NPI | 1255996997 |
---|---|
Former Name | MELANIE MARIE NICHOLS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP141369) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP141369) |
Enumeration Date | 2019-05-08 |
Last Update Date | 2019-05-08 |