Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 209015522 | IL |
NPI | 1013455518 |
---|---|
Provider Name | Viviane Che |
First Address | Las Vegas, NV 89133-5380 |
Second Address | Phoenix, AZ 85027-4255 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2017 |
Last Update Date | 17/02/2020 |