NPI | 1295100345 |
---|---|
Former Name | ASHLEY ELIZABETH BLACKBURN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3009819) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3009819) |
Enumeration Date | 2015-12-01 |
Last Update Date | 2020-10-01 |