| NPI | 1720217680 |
|---|---|
| Former Name | LENA ROSE ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5004412) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5004412) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2018-08-17 |