NPI | 1376586362 |
---|---|
Former Name | HEIDI O'DAY SHULTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95002267) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 17314-5) |
Enumeration Date | 2006-06-14 |
Last Update Date | 2018-09-19 |