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 | 261QC1500X | Clinic/Center | Community Health | | | No |
| 2 | 261QC1800X | Clinic/Center | Corporate Health | | | No |
| 3 | 261QH0100X | Clinic/Center | Health Service | | | No |
| 4 | 261QM0850X | Clinic/Center | Adult Mental Health | | | No |
| 5 | 261QP2300X | Clinic/Center | Primary Care | | | No |
| 6 | 261QR1100X | Clinic/Center | Research | | | No |
| 7 | 261QS1000X | Clinic/Center | Student Health | | | No |
| 8 | 261QV0200X | Clinic/Center | VA | | | No |
| 9 | 261QX0100X | Clinic/Center | Occupational Medicine | | | No |
| 10 | 332900000X | Non-Pharmacy Dispensing Site | | | | No |
| 11 | 363LF0000X | Nurse Practitioner | Family | | | No |
| 12 | 364SC1501X | Clinical Nurse Specialist | Community Health/Public Health | | | No |
| 13 | 261QU0200X | Clinic/Center | Urgent Care | | | Yes |