Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | JAM1-0437-1323 | MN |
NPI | 1245585926 |
---|---|
Provider Name | Bria M James |
First Address | Waconia, MN 55387-1072 |
Second Address | Waconia, MN 55387-1072 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2012 |
Last Update Date | 18/07/2012 |