NPI | 1609178987 |
---|---|
Former Name | TERESA LYNN SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209008489) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11006732) |
363LF0000X Nurse Practitioner, Family (Licence: IN 71005686A) | |
Enumeration Date | 2010-11-18 |
Last Update Date | 2025-05-22 |