NPI | 1952792459 |
---|---|
Former Name | CALLIE LECROY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11018308) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 77226) |
363LF0000X Nurse Practitioner, Family (Licence: KS 77226) | |
Enumeration Date | 2015-02-05 |
Last Update Date | 2023-04-13 |