NPI | 1548786536 |
---|---|
Former Name | AMBER LYNN HIBBEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 197927) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 197927) |
Enumeration Date | 2017-08-21 |
Last Update Date | 2022-07-21 |