Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 2005-00698 | NC |
NPI | 1245443126 |
---|---|
Provider Name | Nina Jain |
First Address | Morrisville, NC 27560-8442 |
Second Address | Sanford, NC 27330-4159 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 10/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
55908U | (02) | NC |