NPI | 1427783059 |
---|---|
Former Name | AMANDA LEE HERRMANN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71013844A) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 28212026A) |
Enumeration Date | 2022-07-18 |
Last Update Date | 2023-10-10 |