NPI | 1639564313 |
---|---|
Former Name | JUDY ANN LYLES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: KS 14-130459-062) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2010024055) |
Enumeration Date | 2015-03-31 |
Last Update Date | 2015-03-31 |