NPI | 1144956509 |
---|---|
Former Name | MCKENZIE BEAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0031846) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 0031846) |
Enumeration Date | 2022-07-28 |
Last Update Date | 2024-06-12 |