| NPI | 1164145892 |
|---|---|
| Former Name | ANDREA DEFENBAUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11024583) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 13150-33) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 13150) | |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2024-02-29 |