NPI | 1659839611 |
---|---|
Former Name | CRYSTAL KAY RASMUSSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN25508) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN192513) |
Enumeration Date | 2019-03-08 |
Last Update Date | 2022-08-08 |