| NPI | 1861870370 |
|---|---|
| Former Name | MELINDA VESTAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015001953) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76742-071) |
| Enumeration Date | 2015-05-16 |
| Last Update Date | 2016-07-15 |