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Individual
MRS. WANDA E. FOOTE
Active
Individual
MRS. WANDA E. FOOTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
F303483-1
NY
363L00000X
Nurse Practitioner
Primary
SP004968C
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02377948
—
NY
01
—
CC9269
RR MEDICARE
PA
01
—
GU039830
MEDICARE GROUP
PA
01
—
P00286820
RR MEDICARE PIN
PA
Enumeration date
03/23/2006
Last updated
03/04/2021
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