NPI | 1215599303 |
---|---|
Former Name | KRISTIN NIELSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202104212NP-PP) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA 204835) |
Enumeration Date | 2019-06-28 |
Last Update Date | 2021-08-02 |