| NPI | 1134813405 |
|---|---|
| Former Name | SHANNON DULETZKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife (Licence: OR 10009305) |
| Additional Taxonomies | 176B00000X Midwife (Licence: OR 10009305) |
| Enumeration Date | 2023-06-07 |
| Last Update Date | 2023-08-14 |