NPI | 1497100580 |
---|---|
Former Name | KORTNEY MCMULLIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP212553) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 6211903-4405) |
Enumeration Date | 2016-04-26 |
Last Update Date | 2025-01-21 |