NPI | 1003351727 |
---|---|
Former Name | MACKENZIE NICOLE KREBSBACH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AL 1-138001) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL APRN11031315) |
363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11031315) | |
Enumeration Date | 2017-01-04 |
Last Update Date | 2025-06-11 |