NPI | 1457738510 |
---|---|
Former Name | JOY SHANNON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN APN0000019961) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19961) |
Enumeration Date | 2015-04-28 |
Last Update Date | 2022-07-21 |