| NPI | 1912557372 |
|---|---|
| Former Name | BREANNA LEIGH ROUNDTREE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NJ01231600) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 140609) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS TMP-158957) | |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2023-02-24 |