| NPI | 1801996046 |
|---|---|
| Former Name | SUSAN MODAHL,BARNARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 0209150-01) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: MN R056479-5) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MN R056479-5) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2013-11-19 |