Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 209.010052 | IL |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 9404489 | FL |
NPI | 1003151796 |
---|---|
Provider Name | Ms. Kathleen Mary Giroux-Pfister |
First Address | Lake Zurich, IL 60047-3217 |
Second Address | Naples, FL 34102-5656 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2012 |
Last Update Date | 23/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20150720295836 | (05) | IL |