| NPI | 1659343143 |
|---|---|
| Former Name | GRACE A BOURNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SD CP000282) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000282) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2013-12-11 |