NPI | 1528611712 |
---|---|
Other Name | SHANA SE'RAE RICHARDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1032762) |
Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: CO 0201923) |
Enumeration Date | 2019-07-17 |
Last Update Date | 2024-04-24 |