NPI | 1649658030 |
---|---|
Former Name | BIANCA BURNETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9445365) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 183971) |
Enumeration Date | 2015-05-18 |
Last Update Date | 2024-02-14 |