NPI | 1083490858 |
---|---|
Former Name | CHEYENNE THALER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4008945) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 4008945) |
363LA2100X Nurse Practitioner, Acute Care (Licence: OH 0034728) | |
Enumeration Date | 2023-09-06 |
Last Update Date | 2023-09-26 |