NPI | 1881097475 |
---|---|
Former Name | TABER BURLESON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: AZ AP7349) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP7349) |
363LF0000X Nurse Practitioner, Family (Licence: AZ TAP7349) | |
Enumeration Date | 2014-09-26 |
Last Update Date | 2024-01-15 |