NPI | 1114267176 |
---|---|
Former Name | TIA CAMILLE HENSLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 17440) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 12998) |
Enumeration Date | 2013-02-27 |
Last Update Date | 2022-03-30 |