Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 1021336 | TX |
NPI | 1164199782 |
---|---|
Provider Name | Daisy V Christopher |
First Address | Shenandoah, TX 77380-3218 |
Second Address | Shenandoah, TX 77380-3218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2021 |
Last Update Date | 23/08/2021 |