| NPI | 1811660764 |
|---|---|
| Former Name | MERCEDES LONGSHAW OLSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: UT 283800-4405) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: UT 283800-4405) |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2021-07-27 |