NPI | 1669036034 |
---|---|
Former Name | DEBORAH LYNN GARDNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ CNP228212) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: AZ RN189186) |
Enumeration Date | 2019-04-30 |
Last Update Date | 2022-12-22 |