NPI | 1386914273 |
---|---|
Former Name | BONNIE NELSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WY 57131) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WY 29472) |
Enumeration Date | 2012-01-09 |
Last Update Date | 2025-09-09 |