Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | NC |
NPI | 1013064187 |
---|---|
Provider Name | Mrs. Julie Elizabeth Schanno |
First Address | Elizabeth City, NC 27909-3361 |
Second Address | Elizabeth City, NC 27909-3361 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 02/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q55218 | (02) | NC |