Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | ARNP 1492332 | FL |
NPI | 1063473262 |
---|---|
Provider Name | Marjory W Quammie |
First Address | Daytona Beach, FL 32120-9190 |
Second Address | Daytona Beach, FL 32117-5114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2006 |
Last Update Date | 13/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
301357001 | (05) | FL |