NPI | 1699126243 |
---|---|
Former Name | JAMIE LEE CULLUM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO APN.0995039-NP) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 7017-33) |
Enumeration Date | 2016-06-24 |
Last Update Date | 2024-01-03 |