NPI | 1174983878 |
---|---|
Former Name | ANGELA RENEE BUCHANAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 25474) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2015011469) |
363L00000X Nurse Practitioner (Licence: NC 5015653) | |
Enumeration Date | 2016-02-24 |
Last Update Date | 2024-10-18 |