| NPI | 1336498732 |
|---|---|
| Former Name | COLTEDRA SH'NEE ROSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012225) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000016966) |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2020-11-27 |