| 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 |