NPI | 1114357613 |
---|---|
Former Name | CARRIE ELIZABETH HANSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76185) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 268685) |
363LF0000X Nurse Practitioner, Family (Licence: MO 2013034520) | |
Enumeration Date | 2013-11-19 |
Last Update Date | 2024-06-24 |