NPI | 1972225704 |
---|---|
Former Name | SHANNON NICOLE HIGHT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11021241) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL RN9494102) |
Enumeration Date | 2022-09-19 |
Last Update Date | 2023-03-07 |