NPI | 1588242044 |
---|---|
Former Name | LOREN NICOLE WALDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024179895) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001270374) |
Enumeration Date | 2021-03-29 |
Last Update Date | 2021-03-29 |