NPI | 1790087922 |
---|---|
Former Name | SHIRLEY A SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 75119) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 148051) |
363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2010028162) | |
Enumeration Date | 2010-11-19 |
Last Update Date | 2021-08-17 |