| NPI | 1639522873 |
|---|---|
| Former Name | MANDY J. BRUMMELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2025014834) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 277003896) |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2025-06-17 |