| NPI | 1154973253 |
|---|---|
| Former Name | SHELLY M RALSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 314962) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 068632-23) |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2024-10-14 |