| NPI | 1821286170 |
|---|---|
| Former Name | CORY FRAZIER ANTONELLI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11000729) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704300463) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH RN-296830/NP-07044) | |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2019-12-15 |