| NPI | 1679757116 |
|---|---|
| Former Name | SUE ELLEN RAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2001005022) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-97852-042) |
| 163W00000X Registered Nurse (Licence: MO 2001005022) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-46184-042) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2001005022) | |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2022-04-19 |