NPI | 1942851597 |
---|---|
Former Name | EBONI EVANS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN236916) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 30084) |
Enumeration Date | 2019-09-25 |
Last Update Date | 2025-03-25 |