NPI | 1154748556 |
---|---|
Former Name | NICOLE MONIQUE CARTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171598) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024171598) |
Enumeration Date | 2014-03-24 |
Last Update Date | 2023-12-29 |