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 | 208000000X | Pediatrics | | | | No |
| 2 | 208600000X | Surgery | | | | No |
| 3 | 213ES0103X | Podiatrist | Foot & Ankle Surgery | | | No |
| 4 | 363L00000X | Nurse Practitioner | | | | No |
| 5 | 174400000X | Specialist | | | | No |
| 6 | 207N00000X | Dermatology | | | | No |
| 7 | 207V00000X | Obstetrics & Gynecology | | | | No |
| 8 | 207R00000X | Internal Medicine | | | | No |
| 9 | 363LF0000X | Nurse Practitioner | Family | | | No |
| 10 | 207L00000X | Anesthesiology | | | | No |
| 11 | 363AM0700X | Physician Assistant | Medical | | | No |
| 12 | 207X00000X | Orthopaedic Surgery | | | | No |
| 13 | 363LA2200X | Nurse Practitioner | Adult Health | | | No |
| 14 | 363LN0000X | Nurse Practitioner | Neonatal | | | No |
| 15 | 207Q00000X | Family Medicine | | | | Yes |