NPI | 1972119071 |
---|---|
Former Name | JOAN MARIE WELDON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A159875) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A159875) |
Enumeration Date | 2020-09-23 |
Last Update Date | 2024-06-06 |