| NPI | 1346321577 |
|---|---|
| Former Name | MARY SUSAN PIRTLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209015842) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 137448) |
| 363LF0000X Nurse Practitioner, Family (Licence: OR 201600925NP-PP) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2018-05-24 |