| NPI | 1831783000 |
|---|---|
| Former Name | AMANDA SUE BAUSMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3017692) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 29003) |
| Enumeration Date | 2021-02-26 |
| Last Update Date | 2023-08-23 |