| NPI | 1629580519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NM 74494) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9382157) |
| 363L00000X Nurse Practitioner (Licence: NM 74494) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 310606) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ14875500) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95020396) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1057450) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11015365) | |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2024-10-13 |