| NPI | 1144600164 |
|---|---|
| Former Name | COURTNEY BLAKE EVANS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007667) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 253101) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2021-12-20 |