| NPI | 1427481506 |
|---|---|
| Former Name | MICAH GWALTNEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN0992015) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CO APN0992015) |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2022-11-04 |