| NPI | 1285678482 |
|---|---|
| Former Name | CHARISSE ALENE GATHERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN143102) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA RN143102) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2008-07-24 |