| NPI | 1518701671 |
|---|---|
| Former Name | AFTON CHAMBERLYN PARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 8371454) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID 42088) |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2025-07-25 |