Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | NPF95016567 | CA |
NPI | 1023630373 |
---|---|
Provider Name | Amy Parris |
First Address | Sacramento, CA 95865-5228 |
Second Address | Modesto, CA 95355-4201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2020 |
Last Update Date | 26/02/2021 |