| NPI | 1942793427 |
|---|---|
| Former Name | LAUREN NICOLE TERRELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2022039861) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 008953) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2022-12-07 |