NPI | 1821729039 |
---|---|
Former Name | ELLEN BRYN BAKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP025575) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: DE LP-0010054) |
Enumeration Date | 2022-06-19 |
Last Update Date | 2023-09-12 |