NPI | 1588103311 |
---|---|
Former Name | ASHLEY LAUREN LIGHTY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LN0000X Nurse Practitioner Neonatal (Licence: CO 0993286-NP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 1623362) |
Enumeration Date | 2017-02-13 |
Last Update Date | 2017-08-23 |