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 | 261QU0200X | Clinic/Center | Urgent Care | | | No |
| 2 | 305R00000X | Preferred Provider Organization | | | | No |
| 3 | 305S00000X | Point of Service | | | | No |
| 4 | 251E00000X | Home Health | | | | No |
| 5 | 251F00000X | Home Infusion | | | | No |
| 6 | 251J00000X | Nursing Care | | | | No |
| 7 | 251K00000X | Public Health or Welfare | | | | No |
| 8 | 251S00000X | Community/Behavioral Health | | | | No |
| 9 | 261Q00000X | Clinic/Center | | | | No |
| 10 | 261QH0100X | Clinic/Center | Health Service | | | No |
| 11 | 261QI0500X | Clinic/Center | Infusion Therapy | | | No |
| 12 | 261QP2300X | Clinic/Center | Primary Care | | | No |
| 13 | 261QR1300X | Clinic/Center | Rural Health | | | No |
| 14 | 363LP2300X | Nurse Practitioner | Primary Care | | | Yes |