| NPI | 1841952710 |
|---|---|
| Former Name | CHARICE AMBER PHELPS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP002170) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| 363L00000X Nurse Practitioner (Licence: SD CP002170) | |
| Enumeration Date | 2021-10-08 |
| Last Update Date | 2022-04-26 |