NPI | 1528414612 |
---|---|
Former Name | MELISSA ASHLEY BUCKNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5008560) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 238638) |
Enumeration Date | 2016-05-09 |
Last Update Date | 2019-03-21 |