| NPI | 1679207153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5016444) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA GAANP002214) |
| 363LF0000X Nurse Practitioner, Family (Licence: WV 124543) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AL 3001594) | |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 28248) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024191826) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NH 115102-23) | |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2025-11-24 |