NPI | 1518425099 |
---|---|
Former Name | JOSIE JEAN LEATHERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71009903A) |
Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: OH RN.229957) |
Enumeration Date | 2019-03-04 |
Last Update Date | 2023-03-09 |