| NPI | 1629511969 |
|---|---|
| Former Name | AMANDA NICHOLE GORRELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP161193) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ME RN62742) |
| Enumeration Date | 2016-11-18 |
| Last Update Date | 2022-09-09 |