NPI | 1770849127 |
---|---|
Former Name | LINDA RUTH FULLINGTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN APN16616) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN RN159881) |
Enumeration Date | 2012-04-10 |
Last Update Date | 2022-05-04 |