NPI | 1568961456 |
---|---|
Former Name | TAMEKA RUCKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN203695) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-165183) |
Enumeration Date | 2018-02-06 |
Last Update Date | 2020-05-27 |