NPI | 1336569243 |
---|---|
Other Name | AMANDA PACKERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 1040) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN F0114453) |
Enumeration Date | 2014-04-17 |
Last Update Date | 2023-03-28 |