Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 672348 | TX |
NPI | 1104889393 |
---|---|
Provider Name | Mrs. Christina Frederike Ullrich |
First Address | Trophy Club, TX 76262-3101 |
Second Address | Richardson, TX 75082-3542 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2006 |
Last Update Date | 29/05/2008 |