Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | ARNP9219851 | FL |
N | 363LA2200X | Nurse Practitioner - Adult Health | 9219851 | FL |
NPI | 1023265527 |
---|---|
Provider Name | Mrs. Laura Kizer Myrold |
First Address | Orlando, FL 32806-2134 |
Second Address | Orlando, FL 32806-2134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2008 |
Last Update Date | 09/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000369100 | (05) | FL |
ARNP9219851 | MEDICAL LICENSE (01) | FL |