NPI | 1386020063 |
---|---|
Former Name | RONNIE SUE DEARDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MA CNPRN234540) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: MA RN234540) |
163WM0705X Registered Nurse, Medical-Surgical (Licence: MA RN234540) | |
363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: MA CNPRN234540) | |
Enumeration Date | 2015-08-05 |
Last Update Date | 2022-08-03 |