NPI | 1427396068 |
---|---|
Former Name | MAIJA CARRIE NELSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA NP95005696) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209010270) |
363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3009369) | |
Enumeration Date | 2013-01-16 |
Last Update Date | 2017-01-12 |