Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | SP013938 | PA |
Y | 363LA2100X | Nurse Practitioner - Acute Care | SP013938 | PA |
NPI | 1003135781 |
---|---|
Provider Name | Mrs. Elena Yurievna Nebrat |
First Address | Harrisburg, PA 17104-1612 |
Second Address | Harrisburg, PA 17104-1619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2010 |
Last Update Date | 21/08/2017 |