Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 9108 | TX |
N | 111NN1001X | Nutrition | 9108 | TX |
N | 111NX0100X | Occupational Health | 9108 | TX |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 9108 | TX |
NPI | 1144233842 |
---|---|
Provider Name | Dr. Rosanna D Hardin |
First Address | El Paso, TX 79996-2038 |
Second Address | El Paso, TX 79935-3513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 19/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1680860 | (05) | TX |
606391 | BLUE CROSS BLUE SHIELD (01) | TX |