NPI | 1477079861 |
---|---|
Former Name | CARISSA NICOLE MYERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NJ15094400) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 23054) |
363LG0600X Nurse Practitioner, Gerontology (Licence: TN 23054) | |
Enumeration Date | 2017-08-17 |
Last Update Date | 2024-11-08 |