Name | Value |
---|---|
PROVIDER TYPE | Nursing Service Providers |
CLASSIFICATION | Registered Nurse |
AREA OF SPECIALIZATION | Urology |
STATUS | Active |
VA CODE | V070951 |
X12 CODE | 163WU0100X |
INDIVIDUAL/NON | INDIVIDUAL |
MASTER ENTRY FOR VUID | YES |
VUID | 5253008 |
EFFECTIVE DATE/TIME |
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