NPI | 1831152032 |
---|---|
Former Name | RETA L VINING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 200450030NP ANP PP) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2011031615) |
363LA2200X Nurse Practitioner, Adult Health (Licence: WA 60081469) | |
363LA2200X Nurse Practitioner, Adult Health (Licence: OH 08652) | |
Enumeration Date | 2006-04-10 |
Last Update Date | 2016-08-16 |