| NPI | 1114511276 |
|---|---|
| Former Name | CHANELL O'ROURKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202114157NP-PP) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MI 4704345839) |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2022-04-14 |