NPI | 1124557715 |
---|---|
Former Name | MARGIE LOUISE ECCLESTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202100467NP-PP) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OR 201707942) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60889600) | |
Enumeration Date | 2017-06-07 |
Last Update Date | 2024-08-19 |