NPI | 1821488099 |
---|---|
Former Name | RENATTA NICOLE WHITE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: SC 18926) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-016828) |
363L00000X Nurse Practitioner (Licence: SC 18926) | |
Enumeration Date | 2015-01-27 |
Last Update Date | 2021-11-03 |