NPI | 1265044747 |
---|---|
Former Name | MELYSSA CARLSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ 259493) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: WA RN60945219) |
163WE0003X Registered Nurse, Emergency (Licence: AZ 259493) | |
Enumeration Date | 2020-08-17 |
Last Update Date | 2024-11-25 |