NPI | 1194069948 |
---|---|
Former Name | LEAH SUZANNE GIBBS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN APN0000012736) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN112452) |
Enumeration Date | 2012-11-18 |
Last Update Date | 2012-11-18 |