NPI | 1790160521 |
---|---|
Former Name | LAUREL ANN STATON-SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201505797NP-PP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60583839) |
163W00000X Registered Nurse (Licence: OR 201141388RN) | |
363LF0000X Nurse Practitioner, Family (Licence: WA AP60583470) | |
Enumeration Date | 2015-07-22 |
Last Update Date | 2023-12-29 |