Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | SP007573 | PA |
NPI | 1073629085 |
---|---|
Provider Name | Ann Marie Sommer |
First Address | York, PA 17402-9001 |
Second Address | York, PA 17403-5151 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 13/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102710061001 | (05) | PA |
50107498 | PA BC (01) | PA |
PO173072 | RAILROAD (01) | PA |
S29699 | (02) |