NPI | 1154047801 |
---|---|
Former Name | ASHLEY ROSE CARLSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61367344) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G171432) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA RN61365832) | |
Enumeration Date | 2022-10-14 |
Last Update Date | 2022-11-21 |