Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 717135 | TX |
NPI | 1083981468 |
---|---|
Provider Name | Jana Gaile Spillers |
First Address | Dallas, TX 75208-2510 |
Second Address | Dallas, TX 75235-7708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2011 |
Last Update Date | 01/12/2011 |