| NPI | 1760432157 |
|---|---|
| Former Name | MICHELLE RENEE PRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71014439A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 7718-33) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 7718-33) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2024-03-15 |