NPI | 1629530993 |
---|---|
Former Name | CANDICE JHEANELL CLARKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP137930) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP137930) |
Enumeration Date | 2019-04-04 |
Last Update Date | 2019-11-14 |