NPI | 1801909916 |
---|---|
Former Name | ANITA CHARLENE FAIRCHILD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/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 |