Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC 27753 | CA |
NPI | 1023133675 |
---|---|
Provider Name | Dr. Ann Marie Ernish |
First Address | Saint Helena, CA 94574-1119 |
Second Address | Saint Helena, CA 94574-1119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 09/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04-3187894 | FEDERAL ID (01) |