Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP109784 | TX |
NPI | 1114447844 |
---|---|
Provider Name | Ms. Alicia Roxanne Labarrie |
First Address | Pearland, TX 77584-8654 |
Second Address | Houston, TX 77054-1906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2017 |
Last Update Date | 16/06/2018 |