NPI | 1255694162 |
---|---|
Former Name | BETH M PRENDERGAST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH COA.13759-NP) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: OH RN.333879) |
Enumeration Date | 2012-06-18 |
Last Update Date | 2017-06-06 |