NPI | 1194506741 |
---|---|
Former Name | NICOLETTE RENEE GAMACHE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 10856) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 10856) |
363LP2300X Nurse Practitioner, Primary Care (Licence: MN 10856) | |
Enumeration Date | 2023-10-10 |
Last Update Date | 2023-11-13 |