Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 1689792 | FL |
NPI | 1013054618 |
---|---|
Provider Name | Mr. Donald Lee Hulen |
First Address | Palm Bay, FL 32905-5402 |
Second Address | Melbourne, FL 32901-3278 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 08/07/2007 |