NPI | 1508165739 |
---|---|
Former Name | AMY N HANSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011007236) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2011007236) |
163W00000X Registered Nurse (Licence: MO 2003009690) | |
Enumeration Date | 2011-03-28 |
Last Update Date | 2021-03-05 |