NPI | 1396098562 |
---|---|
Former Name | EMILY RENEE CUSICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 22468) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 1678229) |
363L00000X Nurse Practitioner (Licence: CA 599565) | |
363LF0000X Nurse Practitioner, Family (Licence: CO 0997112-NP) | |
363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 0997112-NP) | |
Enumeration Date | 2012-10-24 |
Last Update Date | 2023-07-13 |