| NPI | 1679220107 |
|---|---|
| Former Name | AMANDA LEE TAYLOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R240371) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R240371) |
| Enumeration Date | 2022-03-04 |
| Last Update Date | 2022-03-29 |