| NPI | 1255054235 |
|---|---|
| Former Name | CARLY CUTSHAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO APN.0998621-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 100034) |
| 363L00000X Nurse Practitioner (Licence: MN 9551) | |
| Enumeration Date | 2022-09-23 |
| Last Update Date | 2023-09-13 |