| NPI | 1124527668 | 
|---|---|
| Former Name | TABITHA MORGAN LISLE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WA RN60826545)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-132844-071)  | 
| Enumeration Date | 2018-02-11 | 
| Last Update Date | 2018-02-11 |