NPI | 1518954478 |
---|---|
Former Name | LORI HEPPARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 22041) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD AC000116) |
363L00000X Nurse Practitioner (Licence: DE LG0000330) | |
Enumeration Date | 2005-10-05 |
Last Update Date | 2020-08-14 |