NPI | 1760068159 |
---|---|
Former Name | RACHENE ALEXANDER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ01349900) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR14863000) |
363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NJ01349900) | |
Enumeration Date | 2021-03-24 |
Last Update Date | 2024-10-30 |