Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 2607422 | FL |
NPI | 1033145891 |
---|---|
Provider Name | Karin Gertrud D'amico |
First Address | Tallahassee, FL 32308 |
Second Address | Tallahassee, FL 32308-4646 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2006 |
Last Update Date | 08/07/2007 |