| NPI | 1700529724 |
|---|---|
| Former Name | ANNA MARIE CHILDRESS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-179941) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-179941) |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2023-11-15 |