| NPI | 1861584401 |
|---|---|
| Former Name | GORDAYNE EGBERT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 200735) |
| Additional Taxonomies | 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: NC RN034545) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2007-08-16 |