NPI | 1114457892 |
---|---|
Former Name | DAWN LONGCOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: IN 28235617A) |
Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MI 3203046140) |
163W00000X Registered Nurse (Licence: IL 041.372695) | |
163W00000X Registered Nurse (Licence: MI 4704251540) | |
363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209.015571) | |
Enumeration Date | 2017-06-15 |
Last Update Date | 2022-07-21 |