NPI | 1285140285 |
---|---|
Former Name | AMANDA D ELLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71007729A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28160624A) |
363L00000X Nurse Practitioner (Licence: IN 71007729A) | |
Enumeration Date | 2017-12-28 |
Last Update Date | 2023-09-13 |