NPI | 1770959009 |
---|---|
Former Name | TAMARA LOUISE TROUTMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4079) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP 4079) |
363LA2100X Nurse Practitioner, Acute Care (Licence: MN CNP 4079) | |
Enumeration Date | 2015-08-21 |
Last Update Date | 2022-07-21 |