NPI | 1073880605 |
---|---|
Former Name | LORA LYNNE PRIMEAUX |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OK 16467) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TN 31655) |
Enumeration Date | 2011-11-28 |
Last Update Date | 2011-11-28 |