NPI | 1760569065 |
---|---|
Former Name | SHANA KAYE COLLINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71002280A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28133612A) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2023-11-27 |