NPI | 1225796550 |
---|---|
Former Name | MELANIE RENEE WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-82593-111) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 1397315111) |
363LN0000X Nurse Practitioner, Neonatal (Licence: MO 2025013112) | |
Enumeration Date | 2021-12-03 |
Last Update Date | 2025-04-21 |