NPI | 1407252919 |
---|---|
Former Name | FALLON EVANS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.020358) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R200497) |
Enumeration Date | 2014-11-10 |
Last Update Date | 2020-01-31 |