NPI | 1093130635 |
---|---|
Former Name | AMY L PRENTISS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MI 4704263923) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704263923) |
Enumeration Date | 2014-02-19 |
Last Update Date | 2017-03-06 |