Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LG0600X | Nurse Practitioner - Gerontology | RN090627 | AZ |
Y | 363LG0600X | Nurse Practitioner - Gerontology | SP009211 | PA |
NPI | 1063407658 |
---|---|
Provider Name | Dr. Linda L Herrmann |
First Address | Philadelphia, PA 19107-4414 |
Second Address | Philadelphia, PA 19107-4414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 02/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P22514 | (02) |