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Individual
RAE ANN IAMS
Active
Individual
RAE ANN IAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60403597
WA
363LF0000X
Family Nurse Practitioner
AP 60403597
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2033476
—
WA
01
—
AP60403597
WA LICENSE ARNP
WA
01
—
G000188100
GROUP PTAN(K)
WA
01
—
G001045700
GROUP PTAN(P)
WA
Enumeration date
08/07/2013
Last updated
08/26/2020
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