NPI | 1730644824 |
---|---|
Former Name | MEGAN RACHELLE VALLANCE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3015539) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-153253) |
363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3015539) | |
Enumeration Date | 2019-02-04 |
Last Update Date | 2021-02-01 |