NPI | 1336620616 |
---|---|
Former Name | MOLLY BETH WARREN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5378596) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019003829) |
Enumeration Date | 2018-08-24 |
Last Update Date | 2022-01-06 |