NPI | 1972136968 |
---|---|
Former Name | MICHELLE LYNN HENAGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP145150) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP145150) |
Enumeration Date | 2020-02-18 |
Last Update Date | 2022-11-18 |