NPI | 1396909826 |
---|---|
Former Name | ELLEN NOREEN WALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 11644569-4405) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV APRN00223) |
363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: NV APN223) | |
Enumeration Date | 2008-07-14 |
Last Update Date | 2022-02-03 |