Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MD017517E | PA |
NPI | 1578567921 |
---|---|
Provider Name | Dr. Wilma C Light |
First Address | Latrobe, PA 15650-1978 |
Second Address | Latrobe, PA 15650-1978 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2005 |
Last Update Date | 28/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0006055920001 | (05) | PA |
0480153 | AETNA (01) | PA |
101296 | BEST HEALTH (01) | PA |
101296 | UPMC (01) | PA |
140772 | HIGHMARK (01) | PA |
5348794 | FIRST HEALTH (01) | PA |
66243 | MED PLUS (01) | PA |
9973519002 | CIGNA (01) | PA |
C31539 | (02) | PA |