NPI | 1134460207 |
---|---|
Former Name | GANIELLE CHAPPELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN271087) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD 20171710) |
Enumeration Date | 2013-03-13 |
Last Update Date | 2018-09-20 |