NPI | 1942439898 |
---|---|
Former Name | LELA PEAVY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 13997-33) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 137770-030) |
Enumeration Date | 2009-07-13 |
Last Update Date | 2023-05-25 |