NPI | 1740640309 |
---|---|
Former Name | LATIA M COLVIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ00620600) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NJ 26NR17683300) |
363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00620600) | |
Enumeration Date | 2016-02-25 |
Last Update Date | 2024-02-06 |