NPI | 1407003098 |
---|---|
Former Name | JULIE ANN LIVELY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA 10439-NP) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH RN 311853) |
Enumeration Date | 2008-08-26 |
Last Update Date | 2013-06-05 |