Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 21348 | CA |
NPI | 1033496351 |
---|---|
Provider Name | Laura Elise Hiday |
First Address | Loma Linda, CA 92354 |
Second Address | San Bernardino, CA 92415-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2011 |
Last Update Date | 02/03/2017 |