Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 95015757 | CA |
NPI | 1013517960 |
---|---|
Provider Name | Kristina Pulliam Markey |
First Address | Rancho Cucamonga, CA 91730-8314 |
Second Address | Loma Linda, CA 92354 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2020 |
Last Update Date | 29/10/2020 |