NPI | 1639329105 |
---|---|
Former Name | HEATHER L OLSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP017272) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9269635) |
363LF0000X Nurse Practitioner, Family (Licence: TN 20025) | |
Enumeration Date | 2008-09-22 |
Last Update Date | 2017-03-20 |