NPI | 1699273037 |
---|---|
Former Name | RACHELLE FULLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2280024) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 2280024) |
Enumeration Date | 2018-01-31 |
Last Update Date | 2019-03-07 |