NPI | 1073801734 |
---|---|
Former Name | MICHELLE K CRAIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71003631A) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28179417A) |
363LF0000X Nurse Practitioner, Family (Licence: IL 209018042) | |
Enumeration Date | 2011-07-15 |
Last Update Date | 2021-09-30 |