NPI | 1831856699 |
---|---|
Former Name | OLIVIA NOELLE PRATHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016639) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3016639) |
Enumeration Date | 2021-11-29 |
Last Update Date | 2024-12-11 |