NPI | 1346631470 |
---|---|
Former Name | LUCRETIA FISHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704281509) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704281509) |
Enumeration Date | 2015-02-11 |
Last Update Date | 2022-08-04 |