NPI | 1013383421 |
---|---|
Former Name | TONYA PUTMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 129677) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 758397) |
Enumeration Date | 2015-08-19 |
Last Update Date | 2023-12-05 |