Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | RN096085-AP05088 | LA |
NPI | 1174854095 |
---|---|
Provider Name | Eugenie G Killian |
First Address | Harahan, LA 70123-4523 |
Second Address | New Orleans, LA 70115-3515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2010 |
Last Update Date | 15/01/2010 |