NPI | 1710320528 |
---|---|
Former Name | AMANDA L. HETTINGA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.14434-NP) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.14434) |
Enumeration Date | 2013-04-10 |
Last Update Date | 2021-05-18 |