NPI | 1275726754 |
---|---|
Former Name | AMANDA CHRISTINE WASHBURN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 3140) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 3140) |
Enumeration Date | 2007-08-20 |
Last Update Date | 2015-02-02 |