NPI | 1558891523 |
---|---|
Former Name | CHRISTIE JANEL LEATH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5009588) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5009588) |
Enumeration Date | 2017-06-13 |
Last Update Date | 2021-12-22 |