Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | AP130881 | TX |
NPI | 1023563616 |
---|---|
Provider Name | Rosangela Ramirez |
First Address | Beaumont, TX 77707-2241 |
Second Address | Beaumont, TX 77707-2241 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2016 |
Last Update Date | 10/11/2016 |