NPI | 1982126306 |
---|---|
Former Name | CRYSTAL ROSE THOMPSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9294210) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F05170126) |
Enumeration Date | 2017-07-07 |
Last Update Date | 2018-07-31 |