| NPI | 1639231699 |
|---|---|
| Former Name | MARY IRENE FUNDERBURK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist Psychiatric/Mental Health (Licence: CO 122769-4807) |
| Additional Taxonomies | 364SP0807X Clinical Nurse Specialist Psychiatric/Mental Health, Child & Adolescent (Licence: CO 122769-4807) |
| 364SP0810X Clinical Nurse Specialist Psychiatric/Mental Health, Child & Family (Licence: CO 122769-4807) | |
| 364SP0809X Clinical Nurse Specialist Psychiatric/Mental Health, Adult (Licence: CO 122769-4807) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2023-03-07 |