NPI | 1396010799 |
---|---|
Former Name | SHAWNA M FROST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-01954) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0991787-NP) |
Enumeration Date | 2012-03-19 |
Last Update Date | 2024-11-14 |