NPI | 1831858604 |
---|---|
Former Name | SHARLYNN D PECK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: ND 201737) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: ND L13677) |
Enumeration Date | 2021-12-09 |
Last Update Date | 2025-02-04 |