| NPI | 1073364592 |
|---|---|
| Former Name | AMANDA ROSE GILLESPIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 15206-33) |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-04-01 |