NPI | 1295080521 |
---|---|
Former Name | KEMBA MCCAIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 4887) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 4887) |
Enumeration Date | 2012-07-24 |
Last Update Date | 2019-09-05 |