NPI | 1194254318 |
---|---|
Former Name | DOROTHY LYNN WARREN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21052) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 21052) |
Enumeration Date | 2017-06-10 |
Last Update Date | 2023-02-03 |