| NPI | 1477079861 |
|---|---|
| Former Name | CARISSA NICOLE MYERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 23054) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 23054) |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2022-12-20 |