NPI | 1275175689 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11004554) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN294164) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5021496) | |
Enumeration Date | 2019-10-17 |
Last Update Date | 2025-05-01 |