NPI | 1336653716 |
---|---|
Former Name | LINDSAY JUNE WARGELIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: IL 209016768) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209016768) |
363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704386262) | |
Enumeration Date | 2017-11-21 |
Last Update Date | 2023-08-02 |