NPI | 1194961979 |
---|---|
Former Name | COLLEEN GAIL CONOVER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN9472930) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00178900) |
363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00178900) | |
Enumeration Date | 2008-12-26 |
Last Update Date | 2024-05-29 |