NPI | 1629679279 |
---|---|
Former Name | CRYSTAL LYNN SANDERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR 125821) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AR 125821) |
Enumeration Date | 2020-11-02 |
Last Update Date | 2024-09-24 |