Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 041239669 | IL |
Y | 363L00000X | Nurse Practitioner | AP60813682 | WA |
NPI | 1003912411 |
---|---|
Provider Name | Patricia Kemerley |
First Address | Salt Lake City, UT 84125-0608 |
Second Address | Seattle, WA 98104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 02/07/2018 |