| NPI | 1801318167 |
|---|---|
| Former Name | NAOMI ANN PEDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 5225) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 1909715) |
| Enumeration Date | 2017-07-08 |
| Last Update Date | 2019-10-22 |