| NPI | 1730794892 |
|---|---|
| Former Name | JULIE MARIE NISSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO APN.0995857-NP) |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2020-09-14 |