NPI | 1487809653 |
---|---|
Former Name | TRUDY MARCELLE GUTSHALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006641) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61520467) |
363LF0000X Nurse Practitioner, Family (Licence: VA 0024168064) | |
Enumeration Date | 2008-12-01 |
Last Update Date | 2024-01-31 |