NPI | 1205386786 |
---|---|
Former Name | AMBER SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010627) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3010627) |
Enumeration Date | 2016-10-10 |
Last Update Date | 2023-03-07 |