NPI | 1518691419 |
---|---|
Former Name | ASHLEY WISEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2308876) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2308876) |
363LF0000X Nurse Practitioner, Family (Licence: MA RN2308876) | |
163W00000X Registered Nurse (Licence: MA RN2308876) | |
Enumeration Date | 2022-07-15 |
Last Update Date | 2024-07-24 |