| NPI | 1871726612 |
|---|---|
| Former Name | SHANNON M KORTEKAAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 335789) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 540332) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2013-10-24 |