NPI | 1679964019 |
---|---|
Former Name | GINGER NICHOLE WELLS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OK R0077265) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: OK R0077265) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP61333001) | |
Enumeration Date | 2015-02-06 |
Last Update Date | 2022-08-12 |