| NPI | 1336927243 |
|---|---|
| Former Name | LANETTE LYNN NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: WI 14426-33) |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2023-09-20 |