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PA-C · NPI 8901234567
| Credential Type | Issued | Expires | PSV Status | Evidence | Status | |
|---|---|---|---|---|---|---|
| License | 2022-01-15 | 2026-01-15 | Verified 2025-01-10 | License.pdf | Current | |
| DEA Registration | 2023-04-01 | 2025-04-10 | Verified 2024-04-01 | DEA.pdf | Expires in 45 days | |
| Board Certification | 2020-06-01 | — | Verified 2024-06-01 | Board cert.pdf | Current | |
| Malpractice Insurance | 2024-07-01 | 2025-07-01 | Current | Certificate.pdf | Current | |
| NPDB | — | — | Queried 2025-02-01 | — | Current |