| NPI | 1790242659 |
|---|---|
| Former Name | CHARLIE ANN ETHRIDGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP140793) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: TX AP140793) |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2019-02-27 |