NPI | 1679929111 |
---|---|
Former Name | BRANDI ALEXANDRIA DEMMONS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.18973-NP) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH RN356643) |
Enumeration Date | 2016-05-13 |
Last Update Date | 2021-11-02 |