NPI | 1396722559 |
---|---|
Former Name | LORI L DEGRAFFENREID |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004706) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71005529A) |
363L00000X Nurse Practitioner (Licence: IN 71005529B) | |
Enumeration Date | 2005-12-29 |
Last Update Date | 2016-10-17 |