| NPI | 1245251164 |
|---|---|
| Former Name | ROBERTA LYNNE MCMULLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: WA AP30004503) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN00096083) |
| 363L00000X Nurse Practitioner (Licence: WA AP30004503) | |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2018-01-31 |