| NPI | 1639379175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN APN0000012828) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3010089) |
| 363L00000X Nurse Practitioner (Licence: TN APN0000012828) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3010089) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 12828) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2018-11-15 |