NPI | 1881008498 |
---|---|
Former Name | SHELLY BARGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AR A004139) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014000660) |
Enumeration Date | 2014-06-12 |
Last Update Date | 2022-01-26 |