NPI | 1326342007 |
---|---|
Former Name | NICOLE WHITE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 255867) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 2264405) |
363LF0000X Nurse Practitioner, Family (Licence: MA RN2264405) | |
363LF0000X Nurse Practitioner, Family (Licence: MD R210152) | |
Enumeration Date | 2011-01-10 |
Last Update Date | 2022-11-23 |