| NPI | 1396987608 |
|---|---|
| Other Name | MARY-ALICE RODSTROM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 201050211NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 333339) |
| 163W00000X Registered Nurse (Licence: KY 1119712) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 10367) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 333339-COA1) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 6004P) | |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2014-09-29 |