NPI | 1760614002 |
---|---|
Former Name | KRISTEN ANN DANESE ALTDOERFFER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP012902) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP012902) |
2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: PA SPo12902) | |
Enumeration Date | 2009-08-20 |
Last Update Date | 2024-11-22 |