Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | 9333 | CA |
NPI | 1083798698 |
---|---|
Provider Name | Madelin Amir |
First Address | Eureka, CA 95503 |
Second Address | Eureka, CA 95503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 08/07/2007 |