NPI | 1508310061 |
---|---|
Former Name | MELANIE JO TWAIT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112087) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 76731) |
Enumeration Date | 2016-08-12 |
Last Update Date | 2016-09-22 |