NPI | 1093286015 |
---|---|
Former Name | SHADARA EDMOND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011293) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LP-0010645) |
363L00000X Nurse Practitioner (Licence: TN 33592) | |
363L00000X Nurse Practitioner (Licence: SC 27576) | |
363L00000X Nurse Practitioner (Licence: AL 3-001270) | |
363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5011293) | |
363LA2200X Nurse Practitioner, Adult Health (Licence: GA Ag03180040) | |
Enumeration Date | 2018-12-17 |
Last Update Date | 2023-07-07 |