NPI | 1417176926 |
---|---|
Former Name | SHAWN COLLEEN VAN BUREN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP 1813602) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 1813602) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2022-04-01 |