NPI | 1760877765 |
---|---|
Former Name | LAURA GRACE GOERGEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP60961186) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95047545) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201905022NP-PP) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95004793) | |
Enumeration Date | 2015-04-06 |
Last Update Date | 2024-06-04 |