| NPI | 1194030445 |
|---|---|
| Former Name | HEIDI DIANE DITTMAR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 103462) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 130820-030) |
| 163W00000X Registered Nurse (Licence: MN R-130332-4) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 4284-33) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MN r-130332-4) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 130820-030) | |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2019-01-07 |