Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F308228-1 | NY |
N | 363LG0600X | Nurse Practitioner - Gerontology | F308228-1 | NY |
NPI | 1033634241 |
---|---|
Provider Name | Shirley Ann Earl |
First Address | Unadilla, NY 13849-2219 |
Second Address | Oneonta, NY 13820-2099 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2017 |
Last Update Date | 08/08/2017 |