NPI | 1689004327 |
---|---|
Former Name | CAROL JOY HANSELMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95000097) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95000097) |
363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95000097) | |
Enumeration Date | 2013-11-15 |
Last Update Date | 2018-09-17 |