NPI | 1083867089 |
---|---|
Former Name | BRANDY JO RENZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71002848A) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71002848A) |
163W00000X Registered Nurse (Licence: IN 28157189A) | |
Enumeration Date | 2008-11-04 |
Last Update Date | 2020-10-28 |