NPI | 1134596802 |
---|---|
Former Name | MICHELLE LYNN PHILLIPE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9238670) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN280179) |
363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9238670) | |
Enumeration Date | 2015-08-28 |
Last Update Date | 2024-05-07 |