NPI | 1144856980 |
---|---|
Former Name | CHELSEA E BOOMER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MO 2023035774) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2020008019) |
Enumeration Date | 2020-03-12 |
Last Update Date | 2024-04-02 |