Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | F334931 | NY |
NPI | 1013026616 |
---|---|
Provider Name | Erika Plaza |
First Address | Minneapolis, MN 55401-1377 |
Second Address | Minneapolis, MN 55401-1377 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 23/02/2015 |