| NPI | 1780775619 |
|---|---|
| Former Name | BREANNE ELIZABETH NUNNALLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R870133) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN211057) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-07-23 |