Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP130403 | TX |
NPI | 1023479227 |
---|---|
Provider Name | Yuka Nelson |
First Address | Houston, TX 77030-1541 |
Second Address | Houston, TX 77030-1534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2016 |
Last Update Date | 09/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00106W | MDCR GRP PTAN (01) | TX |
153449704 | GRP TPI (01) | TX |