| NPI | 1376843888 |
|---|---|
| Former Name | HEIDI LYNN DENNIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 16436) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 163377) |
| 163W00000X Registered Nurse (Licence: CT 096927) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 4541) | |
| Enumeration Date | 2010-10-31 |
| Last Update Date | 2022-09-23 |