NPI | 1740710722 |
---|---|
Former Name | CARRIE ELAINE BISHOP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21254) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC F05170251) |
Enumeration Date | 2017-06-13 |
Last Update Date | 2020-10-15 |