NPI | 1801375779 |
---|---|
Former Name | MEREDYTH TATE REYNOLDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 3012596) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11007268) |
363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3012596) | |
Enumeration Date | 2018-08-10 |
Last Update Date | 2023-07-24 |