| NPI | 1477231314 |
|---|---|
| Former Name | AMANDA LYNN UDELHOVEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 14121-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WI 14121-33) |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2023-09-05 |