NPI | 1043752579 |
---|---|
Former Name | MELODIE GRAHAM HANKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 20670) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 107384) |
Enumeration Date | 2016-11-15 |
Last Update Date | 2023-05-10 |