NPI | 1982909693 |
---|---|
Former Name | SHANNON L DURSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 1315) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WY 33695.1315) |
363L00000X Nurse Practitioner (Licence: WI 4328) | |
Enumeration Date | 2011-01-12 |
Last Update Date | 2022-11-03 |