NPI | 1366604779 |
---|---|
Former Name | CARRIE COLLINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 10066) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11024089) |
363LF0000X Nurse Practitioner, Family (Licence: IL 209030963) | |
Enumeration Date | 2008-06-26 |
Last Update Date | 2024-12-27 |