Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 903772 | MS |
NPI | 1073144333 |
---|---|
Provider Name | Boqin Hu |
First Address | State Line, MS 39362-7112 |
Second Address | Diberville, MS 39540-2421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2020 |
Last Update Date | 27/01/2020 |