NPI | 1346871506 |
---|---|
Former Name | AMANDA LYNN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP022257) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 153511) |
163W00000X Registered Nurse (Licence: PA RN725614) | |
Enumeration Date | 2020-01-27 |
Last Update Date | 2024-08-01 |