NPI | 1801135116 |
---|---|
Former Name | JULIE LORELLE SHUTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 16982) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CA 604522) |
363A00000X Physician Assistant (Licence: CA 1073131) | |
Enumeration Date | 2013-02-06 |
Last Update Date | 2014-03-25 |