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 | 163WH0200X | Registered Nurse | Home Health | | | No |
| 2 | 207QA0505X | Family Medicine | Adult Medicine | | | No |
| 3 | 207QG0300X | Family Medicine | Geriatric Medicine | | | No |
| 4 | 208100000X | Physical Medicine & Rehabilitation | | | | No |
| 5 | 208D00000X | General Practice | | | | Yes |
| 6 | 208VP0000X | Pain Medicine | Pain Medicine | | | No |
| 7 | 2251G0304X | Physical Therapist | Geriatrics | | | No |
| 8 | 2279G0305X | Respiratory Therapist, Registered | Geriatric Care | | | No |
| 9 | 363L00000X | Nurse Practitioner | | | | No |
| 10 | 363LA2200X | Nurse Practitioner | Adult Health | | | No |