NPI | 1831447333 |
---|---|
Former Name | LAURA BETH UNDERDOWN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0990463) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 35091.1380) |
Enumeration Date | 2012-08-15 |
Last Update Date | 2025-01-24 |