Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125.059522 | IL |
N | 111NI0900X | Internist | 125.059522 | IL |
Y | 2084N0400X | Neurologist | ME124725 | FL |
NPI | 1023305646 |
---|---|
Provider Name | Janielle Hyde |
First Address | Tulsa, OK 74104-5647 |
Second Address | Eau Claire, WI 54701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2011 |
Last Update Date | 07/05/2020 |