NPI | 1093148736 |
---|---|
Former Name | ASHLEY ANN CORNWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9254706) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9254706) |
Enumeration Date | 2013-08-16 |
Last Update Date | 2014-03-14 |