NPI | 1043867229 |
---|---|
Former Name | MELISSA HINES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5014432) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95012012) |
Enumeration Date | 2019-08-21 |
Last Update Date | 2021-06-04 |