| NPI | 1811645526 |
|---|---|
| Former Name | HEATHER NICOLE DOCKENDORF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: MA RN2366153) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 8790) |
| Enumeration Date | 2022-03-11 |
| Last Update Date | 2023-08-15 |