| NPI | 1184270506 |
|---|---|
| Former Name | LISA E VANDER MEIDEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: IA K155446) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA K155446) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA K155446) | |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2019-08-12 |