NPI | 1033593223 |
---|---|
Former Name | CARLEEN MARIE BYRD/MCKEEHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN applied for) |
Enumeration Date | 2015-07-17 |
Last Update Date | 2016-08-01 |