NPI | 1245914225 |
---|---|
Former Name | KALEY LAVEIGNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11026849) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9343018) |
Enumeration Date | 2023-06-12 |
Last Update Date | 2023-06-12 |