NPI | 1699251827 |
---|---|
Former Name | SUSAN ELIZABETH SLOCUM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 6035) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2455378) |
Enumeration Date | 2018-07-11 |
Last Update Date | 2019-01-09 |