Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | SP020148 | PA |
NPI | 1053874263 |
---|---|
Provider Name | Maria Michelle Druckman |
First Address | Hummelstown, PA 17036-7000 |
Second Address | Lebanon, PA 17042-7529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2019 |
Last Update Date | 13/04/2019 |