NPI | 1942685151 |
---|---|
Former Name | ELESA L FETTERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0993073) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 92861) |
Enumeration Date | 2015-07-29 |
Last Update Date | 2021-08-13 |