Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | ARNP9179086 | FL |
NPI | 1003861857 |
---|---|
Provider Name | Joanne Elizabeth Sastamoinen |
First Address | St Pete Beach, FL 33706-3904 |
Second Address | St Petersburg, FL 33710-1629 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q07446 | (02) |