NPI | 1417049404 |
---|---|
Former Name | REGINA MARY BROOKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3006374) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001168260) |
363L00000X Nurse Practitioner (Licence: VA 0017138054) | |
363L00000X Nurse Practitioner (Licence: IN 71013431A) | |
Enumeration Date | 2006-09-28 |
Last Update Date | 2024-07-01 |