NPI | 1720457674 |
---|---|
Former Name | DANA MICHELLE FORREST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC NC5008879) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 142963) |
163W00000X Registered Nurse (Licence: TN RN210660) | |
363LF0000X Nurse Practitioner Family (Licence: TN APN20315) | |
Enumeration Date | 2015-09-22 |
Last Update Date | 2023-10-23 |