NPI | 1265702377 |
---|---|
Former Name | DEVON LISA GERSHANECK BA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CO APN.0990596-NP) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO 990596) |
Enumeration Date | 2012-01-05 |
Last Update Date | 2018-10-17 |