NPI | 1215607247 |
---|---|
Former Name | BAILEY ANNE MODESITT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71012772A) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: IN 28225172A) |
Enumeration Date | 2021-09-21 |
Last Update Date | 2022-09-28 |