NPI | 1124532379 |
---|---|
Former Name | MADISON MCCLAIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AR L058032) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: VT 025.0133125) |
Enumeration Date | 2017-11-27 |
Last Update Date | 2017-11-27 |