NPI | 1740544287 |
---|---|
Former Name | JEANIE VICKNAIR DELAUNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA ap06894) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN106424) |
363L00000X Nurse Practitioner (Licence: LA AP06894) | |
Enumeration Date | 2012-06-29 |
Last Update Date | 2019-10-18 |