NPI | 1689028763 |
---|---|
Former Name | ANGELA M CHRISTOPHERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001069) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SD CP001069) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SD CP001069) | |
Enumeration Date | 2016-04-14 |
Last Update Date | 2022-12-29 |