| NPI | 1770198889 |
|---|---|
| Former Name | AMBER N BANNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA RN650416) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP022458) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP022458) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP022458) | |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2021-08-03 |