NPI | 1255757217 |
---|---|
Former Name | PATRICIA BACKUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.15767) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH AG0314007) |
363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3008647) | |
Enumeration Date | 2014-03-13 |
Last Update Date | 2024-11-26 |