NPI | 1164723615 |
---|---|
Former Name | LACRISTA JOI FUQUA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CA 4008) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 587733) |
163W00000X Registered Nurse (Licence: CA 708406) | |
Enumeration Date | 2010-11-14 |
Last Update Date | 2021-12-21 |