NPI | 1669854287 |
---|---|
Former Name | ALICE ANN HERMANSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012373) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP000824) |
367A00000X Advanced Practice Midwife (Licence: NC 567) | |
Enumeration Date | 2015-06-19 |
Last Update Date | 2023-02-13 |