| NPI | 1619341831 |
|---|---|
| Former Name | NICOLE THEVENOT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ AP8413) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: AZ AP8413) |
| 163WH1000X Registered Nurse, Hospice (Licence: MD RN113296) | |
| Enumeration Date | 2015-11-26 |
| Last Update Date | 2021-09-16 |