NPI | 1295043693 |
---|---|
Former Name | JAVINA SHENELL SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 15263) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000172856) |
Enumeration Date | 2010-09-20 |
Last Update Date | 2024-02-23 |