Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 44933 | KS |
NPI | 1699777425 |
---|---|
Provider Name | Mrs. Cheryl A Rajotte |
First Address | Pittsburg, KS 66762-2546 |
Second Address | Pittsburg, KS 66762-2546 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 08/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S39599 | (02) | KS |