NPI | 1053569541 |
---|---|
Former Name | MELANIE DAWN ANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C145924) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 669125) |
Enumeration Date | 2008-09-09 |
Last Update Date | 2017-01-17 |