NPI | 1568944361 |
---|---|
Former Name | BRANDY J ALLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 277001304) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.017694) |
Enumeration Date | 2018-08-29 |
Last Update Date | 2025-03-20 |