Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 163W00000X | Registered Nurse | | | | No |
| 2 | 207ZP0102X | Pathology | Anatomic Pathology & Clinical Pathology | | | No |
| 3 | 208600000X | Surgery | | | | No |
| 4 | 163WI0500X | Registered Nurse | Infusion Therapy | | | No |
| 5 | 163WW0000X | Registered Nurse | Wound Care | | | No |
| 6 | 207Q00000X | Family Medicine | | | | No |
| 7 | 213ES0103X | Podiatrist | Foot & Ankle Surgery | | | No |
| 8 | 225X00000X | Occupational Therapist | | | | No |
| 9 | 2471V0106X | Radiologic Technologist | Vascular-Interventional Technology | | | No |
| 10 | 332B00000X | Durable Medical Equipment & Medical Supplies | | | | No |
| 11 | 363A00000X | Physician Assistant | | | | No |
| 12 | 363LC1500X | Nurse Practitioner | Community Health | | | No |
| 13 | 363LP0808X | Nurse Practitioner | Psychiatric/Mental Health | | | No |
| 14 | 363LF0000X | Nurse Practitioner | Family | | | No |
| 15 | 213E00000X | Podiatrist | | | | Yes |