NPI | 1144664665 |
---|---|
Former Name | DEETTA KAY CLOUSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71004949A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2012023980) |
163W00000X Registered Nurse (Licence: IN 28178817A) | |
163WH1000X Registered Nurse, Hospice (Licence: KS 120654) | |
363LF0000X Nurse Practitioner, Family (Licence: MO 2014002636) | |
363LF0000X Nurse Practitioner, Family (Licence: KS 5376265111) | |
Enumeration Date | 2013-04-26 |
Last Update Date | 2018-01-30 |