NPI | 1427169978 |
---|---|
Former Name | AMY LYNN GAUTREAU |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: ME CNP81178) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: ME RN45690) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2015-01-23 |