NPI | 1881998078 |
---|---|
Former Name | GINGER REAVES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1108784) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5375307042) |
Enumeration Date | 2011-01-02 |
Last Update Date | 2023-03-31 |