Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | RN574140 | PA |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | SP010262 | PA |
NPI | 1033353867 |
---|---|
Provider Name | Mrs. Michele Grocki Anglisano |
First Address | Rockland, DE 19732-0191 |
Second Address | Bryn Mawr, PA 19010-3121 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2009 |
Last Update Date | 27/04/2018 |