NPI | 1649522814 |
---|---|
Former Name | RUTH A ELDRIDGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95002445) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ TAP4662) |
Enumeration Date | 2012-10-11 |
Last Update Date | 2023-03-07 |