| NPI | 1003252412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN197433) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN197433) |
| 171000000X Military Health Care Provider | |
| 363LF0000X Nurse Practitioner Family (Licence: GA RN197433) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: GA RN197433) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: GA GA197433) | |
| 363LW0102X Nurse Practitioner Women's Health (Licence: GA RN197433) | |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2022-12-14 |