| NPI | 1285498634 |
|---|---|
| Former Name | MARESA LORENE HORNBAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 115193) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A178067) |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2024-03-28 |