Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Clinic/Center |
261Q00000X | |||
Primary Care |
261QP2300X | |||
Public Health, State or Local |
261QP0905X |
| NPI Number | 1003630484 |
| LBN Legal business name | MY PLACE FOR MEDICAL, LLC |
| Authorized official | MAUREEN PLACE - (FAMILY NURSE PRACTITIONER / OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 11/12/2024 |
| Last updated | 04/30/2025 - More than a year ago |
| Identifiers | n/a |
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