NPI | 1275924433 |
---|---|
Former Name | NEELY RICHARDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024185660) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LG-0000992) |
363LF0000X Nurse Practitioner, Family (Licence: NC 5007466) | |
Enumeration Date | 2015-02-10 |
Last Update Date | 2024-02-26 |