| NPI | 1871373282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 10822) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 14731-33) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: WI 14731-33) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: MN 10822) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: MN 10822) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: WI 14731-33) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: WI 14731-33) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: MN 10822) | |
| Enumeration Date | 2023-10-03 |
| Last Update Date | 2025-01-10 |