| NPI | 1205410040 |
|---|---|
| Former Name | RANDI L ULLRICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 10938-33) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 10938-33) |
| Enumeration Date | 2021-05-07 |
| Last Update Date | 2024-05-06 |