| NPI | 1336192707 |
|---|---|
| Former Name | AMANDA LEA PEOT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 2563-033) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 134756-030) |
| 163W00000X Registered Nurse (Licence: WI 134756-30) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2011-03-09 |