Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | ARNP9492463 | FL |
NPI | 1033699855 |
---|---|
Provider Name | Nicole Recine |
First Address | Oakland, CA 94607-3736 |
Second Address | San Francisco, CA 94105-3174 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2018 |
Last Update Date | 21/08/2018 |