NPI | 1942741889 |
---|---|
Former Name | LADONNA RENEE HARRIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 22371) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 902018) |
Enumeration Date | 2017-03-11 |
Last Update Date | 2018-03-01 |