Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | ARNP 2623762 | FL |
Y | 363LW0102X | Nurse Practitioner - Women's Health | ARNP 2623762 | FL |
NPI | 1033427406 |
---|---|
Provider Name | Mrs. Connie Rhoades Killam |
First Address | Pensacola, FL 32501-6339 |
Second Address | Pace, FL 32571-8321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2010 |
Last Update Date | 20/09/2010 |