| NPI | 1184049926 |
|---|---|
| Former Name | DONNA RAE FOSSETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 26968) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 82967) |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2023-11-03 |