| NPI | 1477949816 |
|---|---|
| Former Name | BREIGHANNA WALLIZER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: DE LP-0000237) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0051803) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: MD R175210) | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2019-08-16 |