NPI | 1760535645 |
---|---|
Former Name | CATHY DAWN CONWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA 057774) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN057774) |
Enumeration Date | 2007-01-22 |
Last Update Date | 2015-05-18 |