Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | SP019607 | PA |
NPI | 1518519636 |
---|---|
Provider Name | Hadiza M Fox |
First Address | Harrisburg, PA 17110-9720 |
Second Address | Harrisburg, PA 17110-9720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2019 |
Last Update Date | 09/07/2019 |