NPI | 1346625142 |
---|---|
Former Name | REBECCA NICOLE GRISCOM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 20483) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 153484) |
Enumeration Date | 2015-07-22 |
Last Update Date | 2015-11-19 |