Physician Assistants & Advanced Practice Nursing Providers (667) PERSON CLASS (8932.1)
Name
Value
PROVIDER TYPE
Physician Assistants & Advanced Practice Nursing Providers
CLASSIFICATION
Nurse Practitioner
AREA OF SPECIALIZATION
Pediatrics
STATUS
Active
VA CODE
V100611
X12 CODE
363LP0200X
SPECIALTY CODE
50
INDIVIDUAL/NON
INDIVIDUAL
MASTER ENTRY FOR VUID
YES
VUID
5253380
EFFECTIVE DATE/TIME
2018-04-02 15:35:18
STATUS: ACTIVE
