NPI | 1033828207 |
---|---|
Former Name | CELENA NICOLE UPCHURCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5017424) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 10011737) |
163WP0808X Registered Nurse, Psych/Mental Health (Licence: AZ 294831) | |
163WP0808X Registered Nurse, Psych/Mental Health (Licence: SC 205549) | |
Enumeration Date | 2022-11-16 |
Last Update Date | 2023-12-22 |