| NPI | 1063889749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007941) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 22927) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0037003) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 4008145) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WV 117269) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 34545) | |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN288989) | |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2025-09-03 |