NPI | 1013610864 |
---|---|
Former Name | AMANDA PAIGE STUEMKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 27192) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 27192) |
Enumeration Date | 2023-03-22 |
Last Update Date | 2023-03-22 |