| NPI | 1104127661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN66322-FNP-BC) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 66322) |
| 163W00000X Registered Nurse (Licence: VA 0001226351) | |
| 163W00000X Registered Nurse (Licence: VA 0024169079) | |
| Enumeration Date | 2010-11-15 |
| Last Update Date | 2020-04-21 |