NPI | 1003101536 |
---|---|
Former Name | MELISSA ANN VONDERHEIDE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024169415) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024169415) |
Enumeration Date | 2011-06-13 |
Last Update Date | 2021-07-09 |