Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | AP131956 | TX |
NPI | 1023476082 |
---|---|
Provider Name | Priscilla Boahemaa |
First Address | Spring, TX 77388-5365 |
Second Address | Spring, TX 77388-5365 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2016 |
Last Update Date | 15/09/2021 |