NPI | 1952817397 |
---|---|
Former Name | TERESA MARIE LINES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71007683A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28145560A) |
363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71007683A) | |
Enumeration Date | 2017-12-21 |
Last Update Date | 2022-12-15 |