NPI | 1538530563 |
---|---|
Former Name | SKYLAR VICTORIA DERIGHT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: TN APN20676) |
Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: TN 20676) |
163W00000X Registered Nurse (Licence: TN RN0000203086) | |
Enumeration Date | 2015-10-16 |
Last Update Date | 2020-09-28 |