Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | SP007196 | PA |
NPI | 1205937182 |
---|---|
Provider Name | Carol S Hasse-Jungkurth |
First Address | Wilmington, DE 19801-5162 |
Second Address | Wilmington, DE 19801-5162 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 19/11/2021 |