Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 95013600 | CA |
NPI | 1215569546 |
---|---|
Provider Name | Christine Matthews-Patrick |
First Address | Las Vegas, NV 89139-7648 |
Second Address | San Francisco, CA 94143-2351 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2020 |
Last Update Date | 05/02/2020 |