NPI | 1669788378 |
---|---|
Former Name | MICHELLE LYNN WHETZEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 19833) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP010759) |
Enumeration Date | 2010-08-19 |
Last Update Date | 2016-02-03 |