| NPI | 1568078616 |
|---|---|
| Former Name | JOANNA KAY FALES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 7938) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A160745) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 102720-875) | |
| Enumeration Date | 2020-09-23 |
| Last Update Date | 2025-04-04 |