NPI | 1417552092 |
---|---|
Former Name | MISTY DAWN CYPHERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209022075) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209022075) |
Enumeration Date | 2020-12-02 |
Last Update Date | 2024-12-16 |