Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 1312852 | FL |
NPI | 1003326935 |
---|---|
Provider Name | Mrs. Jean Marie Houy |
First Address | Sunrise, FL 33323-2843 |
Second Address | Pensacola, FL 32504-8721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2017 |
Last Update Date | 05/10/2017 |