NPI | 1619475779 |
---|---|
Former Name | HEATHER RENEE BANKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71007791A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28164199A) |
363LF0000X Nurse Practitioner, Family (Licence: IN 71007791A) | |
363LF0000X Nurse Practitioner, Family (Licence: IN 7100791A) | |
Enumeration Date | 2018-01-24 |
Last Update Date | 2025-06-20 |