| NPI | 1366819971 |
|---|---|
| Former Name | MICHELE LYNN CUSACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209012995) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61333948) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 209.012995) | |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2023-12-12 |