NPI | 1114301165 |
---|---|
Former Name | SHELLY HAMMEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP015543) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC 22865) |
363LF0000X Nurse Practitioner Family (Licence: WV APRN 82589-NP-C) | |
363LF0000X Nurse Practitioner Family (Licence: PA SP015543) | |
Enumeration Date | 2015-07-18 |
Last Update Date | 2024-06-20 |