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 | 1041C0700X | Social Worker | Clinical | | | No |
| 2 | 163W00000X | Registered Nurse | | | | No |
| 3 | 163WG0000X | Registered Nurse | General Practice | | | No |
| 4 | 171400000X | Health and Wellness Coach | | | | No |
| 5 | 171M00000X | Case Manager/Care Coordinator | | | | No |
| 6 | 261QP2300X | Clinic/Center | Primary Care | | | No |
| 7 | 363L00000X | Nurse Practitioner | | | | No |
| 8 | 363LP2300X | Nurse Practitioner | Primary Care | | | No |
| 9 | 207Q00000X | Family Medicine | | | | Yes |