| NPI | 1740739200 |
|---|---|
| Former Name | ANDREA KATE DYKSTRA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-127051) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704275965) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2025-04-09 |