| NPI | 1487690558 |
|---|---|
| Former Name | LAURIE JEAN FESSENDEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 47814) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 238701) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2022-10-21 |