Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 1053912 | FL |
NPI | 1154533420 |
---|---|
Provider Name | Ms. Mary Elizabeth Dehay |
First Address | Jacksonville, FL 32211-4553 |
Second Address | Jacksonville, FL 32216-1471 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 08/07/2007 |