NPI | 1407050164 |
---|---|
Former Name | MELISSA DIANA MORRIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ME CNP201420) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC 3247) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5003497) | |
Enumeration Date | 2007-06-14 |
Last Update Date | 2021-12-01 |