Individual
MS. JOANNA MI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(714) 273-1614
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6007
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
686975-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
308123
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
308123
NYS NURSE PRACTITIONER LICENSE
NY
01
—
686975-1
NYS NURSING LICENSE
NY
Enumeration date
03/15/2015
Last updated
01/21/2020
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