Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F302081 | NY |
NPI | 1013023043 |
---|---|
Provider Name | Ms. Joy Elaine Schank |
First Address | Penn Yan, NY 14527-1070 |
Second Address | Penn Yan, NY 14527-1070 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01816393 | (05) | NY |
S47996 | (02) | NY |