Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | LM-0000143 | DE |
NPI | 1205145604 |
---|---|
Provider Name | Mrs. Janice E Boc |
First Address | Bear, DE 19701-2049 |
Second Address | Newark, DE 19713-2067 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2010 |
Last Update Date | 02/10/2010 |