| NPI | 1144786229 |
|---|---|
| Former Name | CALLISSA LADNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 903129) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 903129) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 015362) | |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2026-04-06 |