NPI | 1528538196 |
---|---|
Former Name | LORI PAGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.008044) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 10.106681) |
163W00000X Registered Nurse (Licence: FL 9415928) | |
363LF0000X Nurse Practitioner, Family (Licence: CT 12.08044) | |
Enumeration Date | 2018-11-27 |
Last Update Date | 2020-01-17 |