NPI | 1316405905 |
---|---|
Former Name | ANDREA MARIE ALLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NC 5011544) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC ALLE-FVSF53) |
363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5011544) | |
Enumeration Date | 2019-03-04 |
Last Update Date | 2022-08-07 |