NPI | 1689445157 |
---|---|
Former Name | AMANDA GRAVES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH RN.447859) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH 0037283) |
Enumeration Date | 2024-01-12 |
Last Update Date | 2025-04-16 |