NPI | 1760954754 |
---|---|
Former Name | KARESA A MCPHOY-PHILIPPEAU |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 343734) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 308019) |
Enumeration Date | 2019-01-02 |
Last Update Date | 2023-03-07 |