| NPI | 1235482449 |
|---|---|
| Former Name | TRISTA SUZANNE SELF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: CO APN.0992491-NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.1642548) |
| 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: TN RN0000164063) | |
| 363LN0000X Nurse Practitioner, Neonatal (Licence: TX 2206) | |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2023-02-12 |