NPI | 1740884501 |
---|---|
Former Name | CAROLYN ANNE RICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 32744) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP61112898) |
363L00000X Nurse Practitioner (Licence: WA AP61112898) | |
Enumeration Date | 2020-11-23 |
Last Update Date | 2024-01-17 |