| NPI | 1861861734 |
|---|---|
| Former Name | AMANDA JEAN CRAVEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9308703) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9308703) |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2015-10-06 |