NPI | 1255771259 |
---|---|
Former Name | MEGAN MARIE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 37427.1503) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 0990779) |
363L00000X Nurse Practitioner (Licence: CO APN.0990779) | |
163W00000X Registered Nurse (Licence: CO RN.0120052) | |
Enumeration Date | 2013-07-05 |
Last Update Date | 2016-05-27 |