NPI | 1467856591 |
---|---|
Former Name | AYLA LYNN CLEVENGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP014318) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP014318) |
363L00000X Nurse Practitioner (Licence: PA SPS014318) | |
Enumeration Date | 2014-10-17 |
Last Update Date | 2024-08-20 |