Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F300957-1 | NY |
N | 363LP2300X | Nurse Practitioner - Primary Care | 3832885 | NY |
NPI | 1043398340 |
---|---|
Provider Name | Ms. Iris Nagin |
First Address | Norwalk, CT 06850-3852 |
Second Address | Norwalk, CT 06850-3852 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 04/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PENDING | (05) | NY |