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 |