NPI | 1518417641 |
---|---|
Former Name | LARA LYNN MILLIKAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN203833) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN203833) |
Enumeration Date | 2016-10-13 |
Last Update Date | 2020-11-13 |