| NPI | 1518583590 |
|---|---|
| Former Name | VIRGINIA EDITH ANN OTEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 7648) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R2256878) |
| 163W00000X Registered Nurse (Licence: OR 201500721) | |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2020-09-11 |