NPI | 1295275113 |
---|---|
Former Name | COURTNEY LANE NORDINE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201702901NP-PP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD R041703) |
163W00000X Registered Nurse (Licence: OR 201701633RN) | |
Enumeration Date | 2017-02-24 |
Last Update Date | 2017-04-26 |