Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN9248000 | FL |
NPI | 1043677206 |
---|---|
Provider Name | Sarah Kort |
First Address | Rockledge, FL 32955-4306 |
Second Address | Melbourne, FL 32901-3224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2016 |
Last Update Date | 05/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
105430100 | (05) | FL |
NA597 | MEDICARE HF (01) | FL |