NPI | 1003296054 |
---|---|
Former Name | MARY LAUREN CHEEK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5007672) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 229124) |
Enumeration Date | 2015-06-04 |
Last Update Date | 2015-06-12 |