Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | SP025017 | PA |
NPI | 1023779147 |
---|---|
Provider Name | Elizabeth Margaret Reese |
First Address | Nazareth, PA 18064-2811 |
Second Address | Nazareth, PA 18064-2811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2022 |
Last Update Date | 02/01/2022 |