Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | TP006424D | PA |
NPI | 1043528441 |
---|---|
Provider Name | Ellen Aaker Reynolds |
First Address | Pittsburgh, PA 15224 |
Second Address | Pittsburgh, PA 15224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2010 |
Last Update Date | 20/09/2010 |