Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | PENDING | CA |
NPI | 1275844904 |
---|---|
Provider Name | Miss Julie Marie Reaume |
First Address | Palm Springs, CA 92262-4872 |
Second Address | Palm Springs, CA 92262-4872 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2010 |
Last Update Date | 28/06/2010 |