NPI | 1720552755 |
---|---|
Former Name | HANNAH GRACE WALDRIP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MS 904174) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 904010) |
Enumeration Date | 2019-01-12 |
Last Update Date | 2021-01-15 |