NPI | 1093322521 |
---|---|
Former Name | MADELEINE RENEE LOUGEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 33653) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 326684) |
363L00000X Nurse Practitioner (Licence: NC 5014982) | |
Enumeration Date | 2020-09-29 |
Last Update Date | 2023-04-18 |