NPI | 1285904052 |
---|---|
Former Name | REBECCA CAROLINE BURNETTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN255236) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000016131) |
363LF0000X Nurse Practitioner, Family (Licence: SC 19060) | |
Enumeration Date | 2012-01-10 |
Last Update Date | 2021-04-26 |