NPI | 1215343470 |
---|---|
Former Name | ELLYN REYNELL FARRAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: VA 0024171792) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024171792) |
Enumeration Date | 2014-07-09 |
Last Update Date | 2015-02-25 |