NPI | 1235822867 |
---|---|
Former Name | ALLYSON BROOKE PETTIT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 27069) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 27069) |
Enumeration Date | 2023-05-30 |
Last Update Date | 2025-02-06 |