NPI | 1326561135 |
---|---|
Former Name | VIRGINIA DIANE DUCKWORTH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 3-000465) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 902189) |
363L00000X Nurse Practitioner (Licence: AL 3-000465) | |
Enumeration Date | 2017-07-24 |
Last Update Date | 2024-05-21 |