NPI | 1326457243 |
---|---|
Former Name | LYNNETTE CAROL CRUPPER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3008717) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008717) |
Enumeration Date | 2014-08-05 |
Last Update Date | 2024-09-16 |