| NPI | 1568901668 |
|---|---|
| Former Name | ANNMARIE HENDERLONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CO 0992955) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CO 0992955) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: CO 0992955) | |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2024-07-24 |