| NPI | 1518467760 |
|---|---|
| Former Name | GINA M CRANDALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 5683) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 5683) |
| Enumeration Date | 2018-02-14 |
| Last Update Date | 2022-06-01 |