NPI | 1306222419 |
---|---|
Former Name | LAVERN WEBSTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP3300612) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN3300612) |
Enumeration Date | 2015-07-31 |
Last Update Date | 2024-11-19 |