Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | NP 21432 | CA |
NPI | 1073883013 |
---|---|
Provider Name | Donna Kay Bierut |
First Address | Livermore, CA 94550-4485 |
Second Address | Livermore, CA 94550-4485 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2012 |
Last Update Date | 16/09/2015 |