NPI | 1457906448 |
---|---|
Former Name | VICTORIA M PHELPS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71009211A) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3014197) |
Enumeration Date | 2019-08-06 |
Last Update Date | 2020-01-27 |