NPI | 1548713290 |
---|---|
Former Name | LACEY WERNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71006524A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28187969A) |
Enumeration Date | 2016-07-29 |
Last Update Date | 2021-06-15 |