NPI | 1902114549 |
---|---|
Former Name | ASHLEY ANN SOUTHWICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9307506) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9307506) |
Enumeration Date | 2010-09-16 |
Last Update Date | 2022-12-08 |