NPI | 1104310291 |
---|---|
Former Name | KARLA RENE PEDICONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH CNP022599) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R222828) |
Enumeration Date | 2018-06-21 |
Last Update Date | 2019-09-16 |