NPI | 1669082921 |
---|---|
Former Name | DIONNE ELIZABETH SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014180) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1101500) |
Enumeration Date | 2020-08-03 |
Last Update Date | 2025-08-29 |