NPI | 1174998314 |
---|---|
Former Name | LAUREN SMOCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009944) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009944) |
Enumeration Date | 2015-12-13 |
Last Update Date | 2022-08-25 |