Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 4704293696 | MI |
N | 363LP2300X | Nurse Practitioner - Primary Care | 4704293696 | MI |
NPI | 1053931899 |
---|---|
Provider Name | Anna Karolionok |
First Address | Holland, MI 49424-7629 |
Second Address | Holland, MI 49423-7201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2020 |
Last Update Date | 22/04/2020 |