NPI | 1508311853 |
---|---|
Former Name | MARGO B. FREDERICKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60854665) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60845692) |
363LF0000X Nurse Practitioner, Family (Licence: WA AP60854665) | |
Enumeration Date | 2016-08-16 |
Last Update Date | 2023-02-27 |