NPI | 1215439294 |
---|---|
Former Name | CHRISTINE JANELLE DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95010278) |
Additional Taxonomies | 163WM0705X Registered Nurse Medical-Surgical (Licence: TX 736552) |
Enumeration Date | 2018-03-06 |
Last Update Date | 2018-11-07 |