NPI | 1295828499 |
---|---|
Former Name | SHANNON DOUGHTY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME R049265) |
Additional Taxonomies | 104100000X Social Worker (Licence: ME LS7243) |
363LF0000X Nurse Practitioner, Family (Licence: ME AP081371) | |
Enumeration Date | 2006-10-02 |
Last Update Date | 2021-12-15 |