| NPI | 1417020769 |
|---|---|
| Former Name | MEGAN SHANE ROBERTIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA rn263330) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN r213006-2) |
| 363L00000X Nurse Practitioner (Licence: VA 0024167195) | |
| 363L00000X Nurse Practitioner (Licence: MD AC001046) | |
| 363L00000X Nurse Practitioner (Licence: SC 20667) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2018-03-17 |