Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APN000891 | NV |
NPI | 1003988007 |
---|---|
Provider Name | Carol J Daake |
First Address | Reno, NV 89503-4451 |
Second Address | Reno, NV 89503-4451 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
APN000891 | APN LIC (01) | NV |
APN000891 | NV STATE PHARMACY (01) | NV |
P13137 | (02) | NV |