NPI | 1093004483 |
---|---|
Former Name | MONIQUE POLK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH COA.12265-NP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 12265) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH RN.299013) | |
Enumeration Date | 2011-04-06 |
Last Update Date | 2024-08-05 |