NPI | 1740664366 |
---|---|
Former Name | PHILICIA A TEAMER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704270576) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704270576) |
Enumeration Date | 2015-07-14 |
Last Update Date | 2023-09-28 |