NPI | 1861897688 |
---|---|
Former Name | MICHELLE JEAN GREGORY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71005268A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28091767A) |
Enumeration Date | 2014-10-23 |
Last Update Date | 2023-10-23 |