| NPI | 1174154330 |
|---|---|
| Former Name | NICKI LYNN WIRTZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9878-33) |
| Additional Taxonomies | 163WX0200X Registered Nurse, Oncology (Licence: WI 127168-30) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 9878-33) | |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2022-12-16 |