NPI | 1710622758 |
---|---|
Former Name | NICOLE RAE GERTH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71012630A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28240035C) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-05-04 |
Last Update Date | 2022-07-21 |