Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | AP130756 | TX |
NPI | 1164887766 |
---|---|
Provider Name | Mrs. Savannah Sutherland |
First Address | Bay City, TX 77414-3120 |
Second Address | Houston, TX 77030-1521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/12/2015 |
Last Update Date | 28/04/2016 |