| NPI | 1770243768 |
|---|---|
| Former Name | CHARLA LYCAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0997201-NP) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 0997201-NP) |
| Enumeration Date | 2021-12-18 |
| Last Update Date | 2023-09-01 |