NPI | 1164752713 |
---|---|
Former Name | SARAH FELLENZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9171914) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 4343) |
363L00000X Nurse Practitioner (Licence: FL ARNP9171914) | |
Enumeration Date | 2010-01-04 |
Last Update Date | 2019-11-15 |