NPI | 1376174706 |
---|---|
Former Name | CHELSEA T JOSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN204790) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN204790) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ME CNP201052) | |
Enumeration Date | 2020-02-04 |
Last Update Date | 2022-11-02 |