| NPI | 1851953749 |
|---|---|
| Former Name | SHANE MICHELLE BARTHOLOMEW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00915000) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP020199) |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2021-02-22 |