NPI | 1023556867 |
---|---|
Former Name | DANIELLE REINE WEYDERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 32048) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP133136) |
363LF0000X Nurse Practitioner, Family (Licence: CO APN.0001619-NP) | |
Enumeration Date | 2017-01-31 |
Last Update Date | 2022-09-13 |