NPI | 1538641592 |
---|---|
Former Name | MELISSA LUANNE ANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MN 6331) |
Additional Taxonomies | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: SD CP001430) |
Enumeration Date | 2018-09-05 |
Last Update Date | 2019-01-02 |