NPI | 1609536440 |
---|---|
Former Name | CALYPSO NICOLE GRUBB |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: WA AP61247701) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP61247701) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: WA 61250730) | |
363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: WA AP61247701) | |
363LA2100X Nurse Practitioner, Acute Care (Licence: WA 61250730) | |
Enumeration Date | 2021-12-21 |
Last Update Date | 2021-12-29 |