NPI | 1164154621 |
---|---|
Former Name | MALLORY ELAINE CRAYS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71012820A) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71012820A) |
Enumeration Date | 2022-06-24 |
Last Update Date | 2023-03-22 |