Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 118506 | AK |
NPI | 1144764879 |
---|---|
Provider Name | Maria Jessica Chambers |
First Address | Portland, OR 97208-4105 |
Second Address | Anchorage, AK 99508-4615 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2016 |
Last Update Date | 11/01/2017 |