NPI | 1659915924 |
---|---|
Former Name | AMY PENTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN254865) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN254865) |
Enumeration Date | 2019-10-30 |
Last Update Date | 2020-01-14 |