Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LG0600X | Nurse Practitioner - Gerontology | SP021682 | PA |
N | 363LP2300X | Nurse Practitioner - Primary Care | 26NJ01115300 | NJ |
Y | 363LP2300X | Nurse Practitioner - Primary Care | SP021682 | PA |
NPI | 1013311034 |
---|---|
Provider Name | Johanna Troy |
First Address | Philadelphia, PA 19102-2100 |
Second Address | Philadelphia, PA 19107-5125 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2014 |
Last Update Date | 26/03/2021 |