NPI | 1295109809 |
---|---|
Former Name | ABBY TAYLOR PROUTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MD R187154) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP015592) |
363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP015592) | |
Enumeration Date | 2015-11-19 |
Last Update Date | 2019-07-28 |