Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 9388 | CA |
NPI | 1134280746 |
---|---|
Provider Name | Mrs. Deborah Ann Eveland |
First Address | Oakland, CA 94611 |
Second Address | Oakland, CA 94611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 05/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P62896.ZZZ22744Z | (02) | CA |