NPI | 1174916480 |
---|---|
Former Name | BROOKE A POWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9233489) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN9233489) |
Enumeration Date | 2015-03-11 |
Last Update Date | 2024-05-21 |