Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 41242 | TN |
NPI | 1184704330 |
---|---|
Provider Name | Elanita M Vogt |
First Address | Knoxville, TN 37920-1500 |
Second Address | Knoxville, TN 37920-1500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5321 | APN NUMBER (01) |