NPI | 1265776603 |
---|---|
Former Name | BRENDA LYNN KOPPENHAVER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: PA RN566127) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN566127) |
Enumeration Date | 2012-11-26 |
Last Update Date | 2024-01-10 |