is a Nurse Practitioner in , . practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for is 1558313080. The last update date is .
's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!
Provider Profile Detail
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Address | , , |
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Sole Proprietor | -- |
Credentials | -- |
NPI Number Detail
NPI Number | 1558313080 |
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Provider Mailing Address Detail
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State | () |
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Provider's Primary Taxonomy Detail
Speciality | Nurse Practitioner |
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Taxonomy | 363L00000X |
Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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GP1157 | SC | -- | |
GP1202 | SC | -- |
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