Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP139978 | TX |
NPI | 1033675343 |
---|---|
Provider Name | Daniella Carrasco Gorzell |
First Address | San Antonio, TX 78233-5480 |
Second Address | San Antonio, TX 78229-3915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2019 |
Last Update Date | 12/02/2019 |