NPI | 1194046979 |
---|---|
Former Name | CARRIE FORAKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.13591) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209029622) |
363L00000X Nurse Practitioner (Licence: OH COA13591-NP) | |
Enumeration Date | 2010-06-16 |
Last Update Date | 2024-06-14 |