Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 201405791 | OR |
N | 363LA2200X | Nurse Practitioner - Adult Health | 9191709 | FL |
NPI | 1003275843 |
---|---|
Provider Name | Ms. Catherine Chiaradonna |
First Address | Grants Pass, OR 97527 |
Second Address | Grants Pass, OR 97527-5856 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2016 |
Last Update Date | 22/02/2016 |