NPI | 1437406329 |
---|---|
Former Name | EMILY KRISTEN PANHORST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 6621217-4405) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 6621217-4405) |
Enumeration Date | 2012-08-09 |
Last Update Date | 2020-10-23 |