NPI | 1154608719 |
---|---|
Former Name | MICHELLE LYNN FARRELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 5538) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 1-132046) |
Enumeration Date | 2011-11-10 |
Last Update Date | 2015-08-11 |