NPI | 1144299694 |
---|---|
Former Name | REBEKAH VENEZIA BAXTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 003165) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 003165) |
Enumeration Date | 2006-03-16 |
Last Update Date | 2021-06-24 |