Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 200300432 | NC |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 200300432 | NC |
NPI | 1366460560 |
---|---|
Provider Name | Jennifer M Wu |
First Address | Chapel Hill, NC 27599-7579 |
Second Address | Chapel Hill, NC 27514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 01/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
230578 | MEDICARE GROUP NUMBER (01) | NC |
89134TT | (05) | NC |
H83074 | (02) | NC |