Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 572295 | TX |
NPI | 1063694826 |
---|---|
Provider Name | Ms. Diana Hurtado |
First Address | Pearland, TX 77584-1367 |
Second Address | Pearland, TX 77584-1367 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2007 |
Last Update Date | 05/12/2007 |