NPI | 1649361197 |
---|---|
Former Name | AMANDA JEAN EARNEST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11027973) |
Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: FL RN9309351) |
247200000X Technician, Other | |
Enumeration Date | 2006-09-28 |
Last Update Date | 2024-03-22 |