| NPI | 1164417903 |
|---|---|
| Former Name | SONDRA MICHELLE STATUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000005971) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN RN0000067551) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2009-01-12 |