NPI | 1841702586 |
---|---|
Former Name | NANCY MARIE POLK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704214040) |
Enumeration Date | 2017-11-03 |
Last Update Date | 2021-10-24 |