| NPI | 1225201288 |
|---|---|
| Former Name | AMANDA JEANNE DIERKING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3006098) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 852185) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP125268) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3006098) | |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2023-02-19 |