NPI | 1215565460 |
---|---|
Former Name | CRYSTAL ANN PARKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL 1-151057) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-151057) |
Enumeration Date | 2020-03-31 |
Last Update Date | 2025-03-04 |