NPI | 1184244402 |
---|---|
Former Name | BRANDI SHAE ROLLING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-140731) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-140731) |
Enumeration Date | 2020-04-17 |
Last Update Date | 2022-08-12 |