Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 835764 | TX |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP 07176 | LA |
NPI | 1356776512 |
---|---|
Provider Name | Mrs. Carrie Sue Tolbert |
First Address | San Antonio, TX 78229-3539 |
Second Address | San Antonio, TX 78229-3539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2013 |
Last Update Date | 03/02/2016 |