NPI | 1790915775 |
---|---|
Former Name | MEAGHAN KELLY RATHVON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP139719) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP012598) |
Enumeration Date | 2009-07-23 |
Last Update Date | 2019-03-06 |