Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 345 | AK |
NPI | 1245464551 |
---|---|
Provider Name | Mrs. Katherine Elizabeth Carrera |
First Address | San Diego, CA 92103-3323 |
Second Address | Anchorage, AK 99508-4627 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2009 |
Last Update Date | 14/05/2009 |