Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | RN388927 | CA |
NPI | 1083778484 |
---|---|
Provider Name | Laurie Friday Walsh |
First Address | Sacramento, CA 95825-2115 |
Second Address | Sacramento, CA 95825-2115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 03/01/2022 |