Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | AP133989 | TX |
N | 363LG0600X | Nurse Practitioner - Gerontology | AP133989 | TX |
Y | 363LP2300X | Nurse Practitioner - Primary Care | AP133989 | TX |
NPI | 1053821942 |
---|---|
Provider Name | Shova Gurung |
First Address | Carrollton, TX 75007-2628 |
Second Address | Carrollton, TX 75007-2628 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2017 |
Last Update Date | 04/10/2017 |