NPI | 1124622667 |
---|---|
Former Name | RODESIA EDMUNDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1151292) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 28238409A) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN-TEMP3607) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F403920-01) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 266391) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2348902) | |
Enumeration Date | 2020-11-25 |
Last Update Date | 2024-11-21 |