Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 3129082 | FL |
NPI | 1235155409 |
---|---|
Provider Name | Ruthie Johnson Sirmans |
First Address | Winter Springs, FL 32708-6123 |
Second Address | Orlando, FL 32805-1809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 10/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P19073 | (02) | FL |