Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | 396753 | CA |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 396753 | CA |
NPI | 1194931980 |
---|---|
Provider Name | Mrs. Sharon Bacot Carter |
First Address | Redlands, CA 92375-1388 |
Second Address | Moreno Valley, CA 92555-3927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RN396753 | BOARD OF REGISTERED NURSI (01) | CA |