NPI | 1285260786 |
---|---|
Former Name | RACHEL MCKENNA BLANSETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD AC004335) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN265267) |
Enumeration Date | 2020-03-16 |
Last Update Date | 2022-07-19 |