Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 9244800 | FL |
NPI | 1770690125 |
---|---|
Provider Name | Mrs. Alanna Johnson Steaple |
First Address | Quincy, FL 32351-5324 |
Second Address | Quincy, FL 32351-5324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 19/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003218900 | (05) | FL |