| NPI | 1497106447 |
|---|---|
| Former Name | SHELLEY EISENHAUER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 344429) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 667426) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2023-01-21 |