NPI | 1023202207 |
---|---|
Former Name | HEATHER RENEE SLOCUM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA AP05266) |
Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: LA AP05266) |
Enumeration Date | 2007-08-30 |
Last Update Date | 2025-08-13 |