Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 1248 | CA |
NPI | 1245371707 |
---|---|
Provider Name | Darla Schmunk |
First Address | Fall River Mills, CA 96028-0337 |
Second Address | Fall River Mills, CA 96028-0337 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1248 | NURSE PRACTITIONER (01) | CA |