NPI | 1467090423 |
---|---|
Former Name | SHAUNETTE EUBANK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11003160) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11003160) |
Enumeration Date | 2019-12-20 |
Last Update Date | 2024-07-18 |