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 |