NPI | 1720621154 |
---|---|
Former Name | ASHLEY LAINE EVANS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019036577) |
Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: MO 2002015387) |
Enumeration Date | 2019-10-17 |
Last Update Date | 2023-10-30 |