| 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 |