Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 2090742 | FL |
NPI | 1043287428 |
---|---|
Provider Name | Mrs. Joanne Elizabeth Dilella |
First Address | Wauchula, FL 33873-2051 |
Second Address | Wauchula, FL 33873-2051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2006 |
Last Update Date | 26/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
301151800 | (05) | FL |
S37524 | (02) | FL |