NPI | 1508823899 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 18084) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024166934) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 28467) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3008191) | |
Enumeration Date | 2006-04-28 |
Last Update Date | 2024-08-22 |