NPI | 1699959148 |
---|---|
Former Name | VIBE PEARL L GUILLERGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209006841) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209006841) |
163W00000X Registered Nurse (Licence: IL 41286442) | |
Enumeration Date | 2007-12-19 |
Last Update Date | 2017-04-21 |