| NPI | 1003560715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN APN31196) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024186832) |
| 363L00000X Nurse Practitioner (Licence: TN APN31196) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024186832) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TN APN31196) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TN APN31196) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024186832) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024186832) | |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2024-03-19 |