NPI | 1134505993 |
---|---|
Former Name | ANGELICA LAUREN COLEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN215693) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 22593) |
Enumeration Date | 2015-08-04 |
Last Update Date | 2023-08-10 |