NPI | 1902123938 |
---|---|
Former Name | CHARLOTTE W ALLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209012174) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP010385) |
Enumeration Date | 2010-04-30 |
Last Update Date | 2024-11-04 |