NPI | 1013447168 |
---|---|
Former Name | ANGELA K MCCRACKEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704356235) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO RXN.0103213-NP) |
Enumeration Date | 2017-06-12 |
Last Update Date | 2019-09-11 |