NPI | 1942718978 |
---|---|
Former Name | ALISHA BREANNA DEAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2018001757) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2018001757) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AR 213500) | |
Enumeration Date | 2018-01-11 |
Last Update Date | 2023-04-17 |