NPI | 1912464801 |
---|---|
Former Name | SHELBY BRADY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5015358) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 22650) |
Enumeration Date | 2019-02-27 |
Last Update Date | 2024-06-16 |