NPI | 1386994036 |
---|---|
Former Name | KAMESHA DERDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0036366) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH Pn167655) |
Enumeration Date | 2012-09-10 |
Last Update Date | 2024-09-10 |