NPI | 1578000246 |
---|---|
Former Name | KARLA TERESA ROSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013061) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5013061) |
363L00000X Nurse Practitioner (Licence: WA AP60728165) | |
Enumeration Date | 2017-01-19 |
Last Update Date | 2021-05-03 |