NPI | 1679227656 |
---|---|
Former Name | MEREDITH REYNOLDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 224751) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN150600) |
363L00000X Nurse Practitioner (Licence: LA 224751) | |
Enumeration Date | 2022-02-08 |
Last Update Date | 2024-05-24 |