Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP137906 | TX |
NPI | 1376039255 |
---|---|
Provider Name | Jerri Kirchhoff |
First Address | Beaumont, TX 77701 |
Second Address | Beaumont, TX 77701-4606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2018 |
Last Update Date | 20/04/2021 |