| NPI | 1871112110 |
|---|---|
| Former Name | SUSAN LORIE MAXWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN098171) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: GA 098171) |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2022-01-28 |