NPI | 1366048498 |
---|---|
Former Name | LOWANNA FAUSETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1002644) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1002644) |
Enumeration Date | 2020-12-04 |
Last Update Date | 2021-12-07 |