NPI | 1154779700 |
---|---|
Former Name | BRITTANY JEAN GLOCKNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3010110) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010110) |
363L00000X Nurse Practitioner (Licence: IN 71013202A) | |
Enumeration Date | 2016-05-24 |
Last Update Date | 2024-11-07 |