NPI | 1124854609 |
---|---|
Former Name | BRETTANIE NICOLE BLOCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN9477609) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11035360) |
Enumeration Date | 2024-09-11 |
Last Update Date | 2024-09-16 |