Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | AP145094 | TX |
NPI | 1053945550 |
---|---|
Provider Name | Ulda Veneziani |
First Address | Plano, TX 75075-1544 |
Second Address | Mesquite, TX 75150-6802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2020 |
Last Update Date | 24/02/2020 |