| NPI | 1336627199 |
|---|---|
| Former Name | CHARMAIGNE ASHLEIGH THREADGILL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP136453) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 802604) |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2021-10-28 |