| NPI | 1336132927 |
|---|---|
| Former Name | CHERYLL ANN MCLANE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C043448) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 043448) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2007-10-16 |