NPI | 1003881996 |
---|---|
Former Name | JEANNINE SUSAN CONRADE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: KS 74510) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: KS 1346573022) |
Enumeration Date | 2006-02-22 |
Last Update Date | 2007-07-08 |