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 | 207L00000X | Anesthesiology | | | | No |
| 2 | 207LA0401X | Anesthesiology | Addiction Medicine | | | No |
| 3 | 251J00000X | Nursing Care | | | | No |
| 4 | 261QC1800X | Clinic/Center | Corporate Health | | | No |
| 5 | 261QI0500X | Clinic/Center | Infusion Therapy | | | No |
| 6 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | No |
| 7 | 261QM1300X | Clinic/Center | Multi-Specialty | | | No |
| 8 | 261QR1100X | Clinic/Center | Research | | | No |
| 9 | 363LA2100X | Nurse Practitioner | Acute Care | | | Yes |
| 10 | 363LP0808X | Nurse Practitioner | Psychiatric/Mental Health | | | No |
| 11 | 2084B0040X | Psychiatry & Neurology | Behavioral Neurology & Neuropsychiatry | | | No |