NPI | 1245760347 |
---|---|
Former Name | JANELLE SUZANNE EDMONDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 22974) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024187669) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202110418NP-PP) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT NUR-APRN-LIC-178407) | |
Enumeration Date | 2017-06-13 |
Last Update Date | 2024-03-19 |