NPI | 1689824260 |
---|---|
Former Name | KRISTA STAINBROOK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: CO 203516) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CO 40605) |
Enumeration Date | 2008-09-19 |
Last Update Date | 2012-02-13 |