| NPI | 1104471382 |
|---|---|
| Former Name | JUANITA CAROLYN CARRELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA 61359549) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA 207709) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1142633) | |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2024-05-01 |