NPI | 1073503066 |
---|---|
Former Name | HEATHER CHRISTINE MAHONEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP007768) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP007768) |
363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP007767) | |
Enumeration Date | 2005-10-21 |
Last Update Date | 2018-06-20 |