Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | AP07580 | LA |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 04576 | LA |
NPI | 1083010318 |
---|---|
Provider Name | Rose Cuneo |
First Address | Houma, LA 70361-6014 |
Second Address | Houma, LA 70360-5937 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2014 |
Last Update Date | 18/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AP07580 | (05) | LA |