NPI | 1669976742 |
---|---|
Former Name | BROOKE RENEE GARNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001924) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD R042964) |
363LF0000X Nurse Practitioner, Family (Licence: MN 5930) | |
Enumeration Date | 2018-03-22 |
Last Update Date | 2021-01-22 |