NPI | 1992388060 |
---|---|
Former Name | PAMELA DENISE COLEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95017697) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 548317) |
Enumeration Date | 2021-05-05 |
Last Update Date | 2021-09-29 |