NPI | 1699706010 |
---|---|
Former Name | MARY J CUNNINGHAM HOMMINGA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN2157532) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP2157532) |
Enumeration Date | 2006-07-05 |
Last Update Date | 2023-04-12 |