| NPI | 1881835718 |
|---|---|
| Former Name | CORDELIA GRACE BOONE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN202034) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN202034) |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2009-03-24 |