NPI | 1326640830 |
---|---|
Former Name | CHARLENE MICHELE MILLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014708) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3014708) |
Enumeration Date | 2020-11-10 |
Last Update Date | 2022-06-29 |