| NPI | 1033509260 |
|---|---|
| Former Name | OLENA MODENOVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: WA AP60929542) |
| Additional Taxonomies | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: WA 60112232) |
| 363LF0000X Nurse Practitioner Family (Licence: WA AP60929542) | |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2024-11-04 |