| NPI | 1679240253 |
|---|---|
| Former Name | MICHELLE CORREA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ 242247) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 242247) |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2025-03-10 |