NPI | 1851952832 |
---|---|
Former Name | LAURA MAE TERRELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71009241A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 2019012949) |
Enumeration Date | 2019-06-21 |
Last Update Date | 2025-08-05 |