NPI | 1114699287 |
---|---|
Former Name | SHANA HOWERTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 70200) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID 44855) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 70200) | |
Enumeration Date | 2021-09-28 |
Last Update Date | 2023-11-21 |