Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | SP021859 | PA |
NPI | 1356962187 |
---|---|
Provider Name | Julia Mancini |
First Address | Monaca, PA 15061-2537 |
Second Address | Pittsburgh, PA 15224-1334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2020 |
Last Update Date | 04/05/2020 |