| NPI | 1043574783 |
|---|---|
| Former Name | LEAH RAE MALONE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 1224) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 173883 4) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2024-05-03 |