NPI | 1902204258 |
---|---|
Former Name | NIKKI LASHAY DEAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-126856) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9382341) |
Enumeration Date | 2014-12-17 |
Last Update Date | 2017-01-25 |