| NPI | 1174168892 |
|---|---|
| Former Name | HALEY CARISSA DINSMORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704350735) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: MI 4704350735) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2022-11-11 |