| NPI | 1164749917 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4001608) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 341532) | 
| 363L00000X Nurse Practitioner (Licence: MA RN2344955) | |
| 363L00000X Nurse Practitioner (Licence: OH RN308729) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11024639) | |
| 363L00000X Nurse Practitioner (Licence: IN 71015971A) | |
| 363L00000X Nurse Practitioner (Licence: RI APRN02523) | |
| 363L00000X Nurse Practitioner (Licence: PA SP022576) | |
| Enumeration Date | 2010-05-03 | 
| Last Update Date | 2025-10-13 |