Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | ARNP9206349 | FL |
NPI | 1003045857 |
---|---|
Provider Name | Kearston Kylie Perfetto |
First Address | Naples, FL 34109-0493 |
Second Address | Naples, FL 34109-0493 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2009 |
Last Update Date | 14/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ARNP9206349 | FL ST LICENSE (01) | FL |