NPI | 1588111678 |
---|---|
Former Name | BRIANNA SHEA SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010477) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3010477) |
Enumeration Date | 2016-09-06 |
Last Update Date | 2020-11-17 |