| NPI | 1447594486 |
|---|---|
| Former Name | AMANDA JEAN ROBERTS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 17136) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 17136) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2015-08-03 |