NPI | 1174384929 |
---|---|
Former Name | BRETT ALEXANDRA GRANBERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 28376) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC MW8605808) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC MW8805597) | |
Enumeration Date | 2024-01-18 |
Last Update Date | 2024-07-25 |