Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | ARNP1856862 | FL |
NPI | 1346417813 |
---|---|
Provider Name | Mrs. Claire Wieteska Farnell |
First Address | St Petersburg, FL 33701-4630 |
Second Address | St Petersburg, FL 33701-4630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2008 |
Last Update Date | 10/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000956000 | (05) | FL |
Y139W | BLUE CROSS BLUE SHIELD (01) | FL |