Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | AP4057 | AZ |
NPI | 1093000564 |
---|---|
Provider Name | Christine Joyce Nera Urias |
First Address | Phoenix, AZ 85014-5072 |
Second Address | Phoenix, AZ 85014-5061 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2011 |
Last Update Date | 20/04/2015 |