NPI | 1972980274 |
---|---|
Former Name | REBECCA LYNN LICHWALA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.0036242) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9308901) |
Enumeration Date | 2015-05-06 |
Last Update Date | 2024-09-27 |