| NPI | 1861968760 |
|---|---|
| Former Name | SHAWNTAVIA LATRICE POWE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-143824) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DC NP500014926) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL TPAN1615) | |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2024-06-11 |