NPI | 1285172908 |
---|---|
Former Name | LORI LYNN BREVES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201701862NP-PP) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: OR 201041933RN) |
Enumeration Date | 2017-02-01 |
Last Update Date | 2020-11-04 |