NPI | 1275930026 |
---|---|
Former Name | ELLISE CHINN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 9590) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: MN R221785-9) |
Enumeration Date | 2014-11-21 |
Last Update Date | 2023-01-03 |