| NPI | 1124377270 |
|---|---|
| Former Name | CARISSA LEIGH REYES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11002979) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9270473) |
| 163WG0000X Registered Nurse, General Practice (Licence: NY 599181) | |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2020-04-27 |