NPI | 1275198327 |
---|---|
Former Name | IRENE ELIZABETH RUSSELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 25855) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: TN 198102) |
363LF0000X Nurse Practitioner, Family (Licence: TN 25855) | |
Enumeration Date | 2019-05-03 |
Last Update Date | 2022-11-29 |