Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | F401136 | NY |
NPI | 1033360102 |
---|---|
Provider Name | Kathryn Millard |
First Address | Williamsville, NY 14221-5360 |
Second Address | Williamsville, NY 14221-5360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2008 |
Last Update Date | 07/10/2008 |