| NPI | 1548225584 |
|---|---|
| Former Name | ANGELA CAROL COUNTERMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP2645) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ AP5424) |
| 363L00000X Nurse Practitioner (Licence: MI 4704186457) | |
| 363L00000X Nurse Practitioner (Licence: AZ AP2645) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ AP2645) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2024-08-12 |