Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | AG1115073 | NY |
N | 363LG0600X | Nurse Practitioner - Gerontology | AG1115073 | NY |
Y | 363LP2300X | Nurse Practitioner - Primary Care | AG1115073 | NY |
NPI | 1043675952 |
---|---|
Provider Name | Janet An |
First Address | New York, NY 10019-1147 |
Second Address | New York, NY 10019-1147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2015 |
Last Update Date | 03/05/2016 |