NPI | 1285330167 |
---|---|
Former Name | CARLY LYNN LOVE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11024184) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL 11024184) |
Enumeration Date | 2023-02-02 |
Last Update Date | 2024-03-20 |