NPI | 1265802227 |
---|---|
Former Name | ANGELA LEIGH WICKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 25023.APN.RX) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP 2944902) |
Enumeration Date | 2015-10-03 |
Last Update Date | 2022-12-22 |