NPI | 1265140032 |
---|---|
Former Name | CECELIA WITCHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 80577) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 782700) |
363LF0000X Nurse Practitioner, Family (Licence: TX 1106480) | |
Enumeration Date | 2022-11-10 |
Last Update Date | 2024-09-23 |