NPI | 1659807253 |
---|---|
Former Name | BRYNN NICOLE MOYER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209.015901) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.015901) |
Enumeration Date | 2017-05-03 |
Last Update Date | 2021-07-14 |