NPI | 1801340807 |
---|---|
Former Name | CHRISTA FANELLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP016770) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00660100) |
363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ00660100) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NJ00660100) | |
Enumeration Date | 2016-08-08 |
Last Update Date | 2020-08-31 |