Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 0050-02513 | NC |
NPI | 1003949926 |
---|---|
Provider Name | Danielle L Speer |
First Address | Newport, VT 05855-9326 |
Second Address | Newport, VT 05855-9326 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 27/04/2021 |