NPI | 1376102293 |
---|---|
Former Name | AUDRA LYN AUSTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71009047A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28212891A) |
Enumeration Date | 2019-06-13 |
Last Update Date | 2023-04-24 |