NPI | 1053500819 |
---|---|
Former Name | JA-MAE V. SUTHERLIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71009178A) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3005251) |
363LA2100X Nurse Practitioner, Acute Care (Licence: KY 3005251) | |
Enumeration Date | 2007-10-17 |
Last Update Date | 2019-08-05 |