NPI | 1649799040 |
---|---|
Former Name | EMMALEE BIDWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3011718) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3011718) |
363LF0000X Nurse Practitioner, Family (Licence: IN 71007504A) | |
Enumeration Date | 2017-09-18 |
Last Update Date | 2024-07-01 |