| NPI | 1770276081 |
|---|---|
| Former Name | MISTY DAWN PHELAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0033944) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 399029) |
| 163W00000X Registered Nurse (Licence: DC RN500018126) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MD AC006583) | |
| Enumeration Date | 2023-06-01 |
| Last Update Date | 2024-12-10 |