| NPI | 1144531880 |
|---|---|
| Former Name | AVERI LYNN OUTLAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006418) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 139606) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2015-06-02 |