Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F400433 | NY |
NPI | 1033178009 |
---|---|
Provider Name | Ms. Ruthellen Trimmer |
First Address | Huntington, NY 11743-2787 |
Second Address | Huntington, NY 11743-2787 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 22/09/2008 |