NPI | 1104605351 |
---|---|
Former Name | MAKENNA K ADAMS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71015628A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28264344A) |
Enumeration Date | 2023-09-27 |
Last Update Date | 2024-10-03 |