Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | SP024676 | PA |
NPI | 1043976848 |
---|---|
Provider Name | Ms. Desiree Lynn Vazquez |
First Address | Pittsburgh, PA 15239-2937 |
Second Address | Pittsburgh, PA 15224-1722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2021 |
Last Update Date | 19/11/2021 |