NPI | 1013258193 |
---|---|
Former Name | MARY ELIZABETH FAIRCHILDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: SC 18055) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11023774) |
Enumeration Date | 2013-03-14 |
Last Update Date | 2023-03-01 |