| NPI | 1114319746 |
|---|---|
| Former Name | CONNIE MARIE ST. LAURENT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: UT 12218275-4405) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 021522) |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2022-12-11 |