NPI | 1053834705 |
---|---|
Former Name | ANGELA RENEE AMICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21171) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: SC 21171) |
Enumeration Date | 2017-07-24 |
Last Update Date | 2024-10-24 |