NPI | 1316248115 |
---|---|
Former Name | ANTRINA DENISE BRANTLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA 288454) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 19994) |
Enumeration Date | 2010-11-10 |
Last Update Date | 2019-07-22 |