Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP30003213 | WA |
N | 363LP2300X | Nurse Practitioner - Primary Care | AP30003213 | WA |
NPI | 1003922493 |
---|---|
Provider Name | Kitty Carmichael |
First Address | Granite Falls, WA 98252 |
Second Address | Arlington, WA 98223-8912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 05/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9632522 | (05) | WA |
P23334 | (02) |