| NPI | 1639594773 |
|---|---|
| Former Name | TESSA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: IN 71004834A) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: IN 71004834A) |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2022-08-08 |