NPI | 1831405521 |
---|---|
Former Name | RASHONDA R DERICHO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL ARNP9194078) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9194078) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9194078) | |
Enumeration Date | 2010-08-19 |
Last Update Date | 2024-11-19 |