Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | VP005462X | PA |
NPI | 1033392980 |
---|---|
Provider Name | Mrs. Alice L Veitz |
First Address | Paoli, PA 19301-1645 |
Second Address | Paoli, PA 19301-1645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2007 |
Last Update Date | 20/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S64044 | (02) | PA |