NPI | 1518319623 |
---|---|
Former Name | DEEANA LANE BURR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 20329) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 29172) |
Enumeration Date | 2016-07-13 |
Last Update Date | 2025-08-26 |