Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | CNP191265 | ME |
NPI | 1033752464 |
---|---|
Provider Name | Emily Karonis |
First Address | Norway, ME 04268-5645 |
Second Address | Norway, ME 04268-5645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2019 |
Last Update Date | 17/10/2019 |