Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | RN476991 | CA |
NPI | 1225133341 |
---|---|
Provider Name | Stacie Onstad Rohovit |
First Address | Palo Alto, CA 94304-1601 |
Second Address | Palo Alto, CA 94304-1601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 22/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P90250 | (02) | CA |
RN476991 | (05) | CA |