NPI | 1255952065 |
---|---|
Former Name | LAUREN MICHELLE TULLOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000027184) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000191215) |
Enumeration Date | 2020-05-04 |
Last Update Date | 2020-05-04 |