Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP9658 | AZ |
N | 363LP2300X | Nurse Practitioner - Primary Care | AP9658 | AZ |
NPI | 1013452309 |
---|---|
Provider Name | Miss Wilhelmina C. Somera |
First Address | Tucson, AZ 85756-8681 |
Second Address | Tucson, AZ 85756-8681 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2016 |
Last Update Date | 22/12/2016 |