NPI | 1831346204 |
---|---|
Former Name | NIKKI RENEE CASTLEBERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2020014289) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1106348) |
Enumeration Date | 2008-08-27 |
Last Update Date | 2022-07-11 |