| NPI | 1427440767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN CNP 3815) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 203068-3) |
| 163W00000X Registered Nurse (Licence: WI 179063) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 3815) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 10976) | |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2021-11-16 |