NPI | 1659551224 |
---|---|
Former Name | SHELLENE HERBIG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71006754A) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209002670) |
Enumeration Date | 2007-11-12 |
Last Update Date | 2021-03-04 |