NPI | 1053435412 |
---|---|
Former Name | ELIZABETH MCNEILL HEDBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 001000817) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001000817) |
363AM0700X Physician Assistant, Medical (Licence: NC 001000817) | |
Enumeration Date | 2007-03-19 |
Last Update Date | 2024-07-03 |