| NPI | 1053088690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 498871) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 0030255) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WV 110463) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 498871) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: OH 0030255) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 498871) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: WV 110463) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: OH 0030255) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: WV 110463) | |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2025-02-12 |