NPI | 1689195174 |
---|---|
Former Name | JOSHUNDA LATIECE CARSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 904569) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-142177) |
363LF0000X Nurse Practitioner, Family (Licence: TX AP134358) | |
Enumeration Date | 2017-07-05 |
Last Update Date | 2022-11-21 |