NPI | 1245003656 |
---|---|
Former Name | NICOLE GALLEGOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024188839) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001295366) |
163W00000X Registered Nurse (Licence: CA 95132433) | |
163W00000X Registered Nurse (Licence: DC RN500007826) | |
Enumeration Date | 2023-11-07 |
Last Update Date | 2024-08-07 |