| NPI | 1154889640 |
|---|---|
| Former Name | AMANDA MICHELLE VINING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11004217) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: FL 9351190) |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2023-08-18 |