NPI | 1316505670 |
---|---|
Former Name | MELISSA JEAN WATSEK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019023268) |
Additional Taxonomies | 163WX0200X Registered Nurse, Oncology (Licence: MO 2014024546) |
363LF0000X Nurse Practitioner, Family (Licence: KS 53-80212-062) | |
Enumeration Date | 2019-06-03 |
Last Update Date | 2024-05-29 |