NPI | 1215916515 |
---|---|
Former Name | JULIE ANNA WAKELY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 003280) |
Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 1043889967) |
261QM2500X Clinic/Center, Medical Specialty (Licence: CT 1992372403) | |
261QM2500X Clinic/Center, Medical Specialty (Licence: NJ 1992372403) | |
Enumeration Date | 2006-01-13 |
Last Update Date | 2024-02-27 |