| NPI | 1790316040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN1009335) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F01200837) |
| 363LF0000X Nurse Practitioner, Family (Licence: AL 3-000628) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 0035870) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN1009335) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC F01200837) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 3-00628) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 0035870) | |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2025-01-31 |