| 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 |