| NPI | 1982945069 |
|---|---|
| Former Name | CORLISTA ANNE DAMON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: VA 0024170057) |
| Additional Taxonomies | 176B00000X Midwife (Licence: VA 0024170057) |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2023-11-27 |