NPI | 1679133573 |
---|---|
Former Name | ASHLEY LYNETTE BONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX pending) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP141896) |
Enumeration Date | 2019-06-13 |
Last Update Date | 2020-04-07 |