NPI | 1851018949 |
---|---|
Former Name | MELISSA TYSON ALEXANDER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024185237) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001078677) |
363L00000X Nurse Practitioner (Licence: VA 0024185237) | |
Enumeration Date | 2022-10-20 |
Last Update Date | 2022-10-20 |