NPI | 1760126171 |
---|---|
Former Name | SHANITA JONES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 33967) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5016094) |
Enumeration Date | 2022-04-21 |
Last Update Date | 2023-07-25 |