| 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 |