Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 0050-01544 | NC |
NPI | 1215221775 |
---|---|
Provider Name | Mrs. Sallie N Harrell |
First Address | Pleasant Garden, NC 27313-9721 |
Second Address | Pleasant Garden, NC 27313-9721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2011 |
Last Update Date | 01/06/2011 |