NPI | 1225279714 |
---|---|
Former Name | RANDI YVONNE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP010221) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA SP010221) |
163WG0600X Registered Nurse, Gerontology (Licence: PA SP010221) | |
163WH0200X Registered Nurse, Home Health (Licence: PA SP010221) | |
Enumeration Date | 2009-03-13 |
Last Update Date | 2016-07-29 |