NPI | 1689174211 |
---|---|
Former Name | HEATHER POWERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 23933) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175868) |
Enumeration Date | 2018-02-20 |
Last Update Date | 2018-09-20 |