| NPI | 1497009617 |
|---|---|
| Former Name | ANGELICA SHAVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5005833) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5005833) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2016-07-07 |