Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | R37008 | NM |
Y | 363LA2200X | Nurse Practitioner - Adult Health | 16959 | CA |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | R37008 | NM |
NPI | 1205859311 |
---|---|
Provider Name | Toni M Mcfadden |
First Address | Santa Rosa, CA 95403-3634 |
Second Address | Santa Rosa, CA 95403-3634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
45259330 | (05) | NM |
Q11459 | (02) |