NPI | 1659871762 |
---|---|
Former Name | HALEY DANAE REID |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11006222) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN260216) |
363LF0000X Nurse Practitioner, Family (Licence: GA RN260216) | |
Enumeration Date | 2018-02-15 |
Last Update Date | 2020-05-12 |