| NPI | 1801909916 |
|---|---|
| Former Name | ANITA CHARLENE FAIRCHILD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MS R702439) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MS R702439) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2023-02-21 |