| NPI | 1578859518 |
|---|---|
| Former Name | LYDIA MARIE KOERITZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R179498-8) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R179494-8) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN G0611003) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2023-03-27 |