NPI | 1366008237 |
---|---|
Former Name | MELISSA CHILDRESS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN252890) |
Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: GA RN252890) |
363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN252890) | |
363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN252890) | |
Enumeration Date | 2019-05-15 |
Last Update Date | 2024-04-03 |