NPI | 1629334651 |
---|---|
Former Name | SUSAN LYNETTE LORDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID N-45447) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ TAP4415) |
Enumeration Date | 2012-04-04 |
Last Update Date | 2015-01-07 |