Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | ARNP9277780 | FL |
Y | 363LA2100X | Nurse Practitioner - Acute Care | ARNP9277780 | FL |
NPI | 1043630742 |
---|---|
Provider Name | Baoanh Chu |
First Address | Pembroke Pines, FL 33082-1605 |
Second Address | Independence, OH 44131-2569 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2014 |
Last Update Date | 27/09/2017 |