NPI | 1265943088 |
---|---|
Former Name | TIANNA MARIE COLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WP2201X Registered Nurse, Ambulatory Care (Licence: NE 66740) |
Additional Taxonomies | 163WR0400X Registered Nurse, Rehabilitation (Licence: NE 66740) |
Enumeration Date | 2017-10-19 |
Last Update Date | 2017-10-19 |