NPI | 1619203270 |
---|---|
Former Name | CARRISSA BETH CAMPBELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP91062) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ME AP091062) |
Enumeration Date | 2009-11-02 |
Last Update Date | 2019-06-05 |