Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 344139 | NY |
NPI | 1003075854 |
---|---|
Provider Name | Mrs. Kristi Lc Hecker |
First Address | Gloversville, NY 12078-1203 |
Second Address | Fonda, NY 12068-4821 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2008 |
Last Update Date | 11/04/2021 |