Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 0024175509 | VA |
NPI | 1003327420 |
---|---|
Provider Name | Martha I Morolari |
First Address | Norfolk, VA 23507-1904 |
Second Address | Norfolk, VA 23507-1904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2017 |
Last Update Date | 29/12/2020 |