NPI | 1669807335 |
---|---|
Former Name | DEONDRA WHEELER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 19979) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: AL 1-126420) |
Enumeration Date | 2013-09-12 |
Last Update Date | 2016-06-02 |