NPI | 1477129104 |
---|---|
Former Name | PAIGE HUSTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN271922) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN271922) |
Enumeration Date | 2021-06-02 |
Last Update Date | 2022-01-14 |