NPI | 1083037451 |
---|---|
Former Name | MICHELLE LYNN FRESHCOLN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: LA AP07614) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 771977) |
367500000X Nurse Anesthetist, Certified Registered (Licence: TX 126531) | |
Enumeration Date | 2014-01-21 |
Last Update Date | 2017-05-11 |