| NPI | 1295390805 |
|---|---|
| Former Name | PAYTON TEPP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9426) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 226494-30) |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2023-10-20 |