NPI | 1740867803 |
---|---|
Former Name | PAIGE WINTERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80229-071) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-131914-071) |
363L00000X Nurse Practitioner (Licence: KS 53-80229-071) | |
Enumeration Date | 2021-03-25 |
Last Update Date | 2022-01-11 |