NPI | 1275187551 |
---|---|
Former Name | LEEANN CHRISTINE BOUCHONNET |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71009417A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28223755A) |
Enumeration Date | 2019-07-25 |
Last Update Date | 2023-06-29 |