Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | A01350 | AR |
NPI | 1003866195 |
---|---|
Provider Name | Elizabeth Cuevas |
First Address | Merryville, LA 70653-3231 |
Second Address | Orange, TX 77630-6133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P50528 | (02) |