| NPI | 1558774711 |
|---|---|
| Former Name | SELISHIA MICHELLE PATRICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN170614) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA rn170614) |
| 363L00000X Nurse Practitioner (Licence: GA RN170614) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: GA rn170614) | |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2020-05-18 |