NPI | 1053393066 |
---|---|
Former Name | MELISSA SUE GARRISON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9270004) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704194300) |
Enumeration Date | 2005-11-16 |
Last Update Date | 2023-08-29 |