NPI | 1740734748 |
---|---|
Former Name | LAURA LEIGH ANTHONY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP4674) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 4674) |
363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4674) | |
363LF0000X Nurse Practitioner, Family (Licence: WI 7077 - 33) | |
Enumeration Date | 2016-08-08 |
Last Update Date | 2021-08-03 |