| NPI | 1396009858 |
|---|---|
| Former Name | THERESA R MAYLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP014731) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9306821) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 7146) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2024-06-20 |