NPI | 1598292427 |
---|---|
Former Name | AMANDA LYNN HASSELMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71007423A) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28185504A) |
Enumeration Date | 2017-05-23 |
Last Update Date | 2022-11-29 |