Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | AP127501 | TX |
N | 363LG0600X | Nurse Practitioner - Gerontology | AP127501 | TX |
NPI | 1043602378 |
---|---|
Provider Name | Jyothi Mepparamabth |
First Address | Webster, TX 77598-4234 |
Second Address | Webster, TX 77598-4234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2015 |
Last Update Date | 24/02/2015 |