| NPI | 1932627882 |
|---|---|
| Former Name | RAINA KELLY ELDRIDGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 23102) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 23102) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2020-01-14 |