NPI | 1184931420 |
---|---|
Former Name | HEATHER L CARBALLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61595972) |
Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: WA RN00130855) |
Enumeration Date | 2010-09-08 |
Last Update Date | 2024-08-14 |