NPI | 1538673033 |
---|---|
Former Name | LACEY CLAIRE NOLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP135868) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP135868) |
Enumeration Date | 2017-11-21 |
Last Update Date | 2020-01-06 |