NPI | 1730732249 |
---|---|
Former Name | CALLIE SHAREE RANGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP142198) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO APN.0996888-NP) |
363L00000X Nurse Practitioner (Licence: CO RXN.0105913-NP) | |
Enumeration Date | 2019-07-23 |
Last Update Date | 2021-11-18 |