NPI | 1316231392 |
---|---|
Former Name | CARRIE ANN POORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV APRN67240-NP-C) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024172548) |
Enumeration Date | 2011-06-07 |
Last Update Date | 2015-10-14 |