Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | SP008402 | PA |
NPI | 1124115621 |
---|---|
Provider Name | Barbara Fetzer |
First Address | Allentown, PA 18105-1754 |
Second Address | Allentown, PA 18103-6202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 29/01/2018 |