NPI | 1346075652 |
---|---|
Former Name | NICOLE MICHELLE CARLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND 201399) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: FL 9579185) |
Enumeration Date | 2024-09-05 |
Last Update Date | 2025-08-27 |