Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 904170 | MS |
NPI | 1013596170 |
---|---|
Provider Name | Wendy Sarhan |
First Address | Theodore, AL 36582-9682 |
Second Address | Theodore, AL 36582-9682 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2021 |
Last Update Date | 06/04/2021 |