| NPI | 1538547849 |
|---|---|
| Former Name | LYNETTE MARIE (1) ALLEN, (2) BRAACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: OR 200742527RN) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2015-05-11 |