| NPI | 1871926766 |
|---|---|
| Former Name | MEGAN LESLEE MORTENSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G123245) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A123245) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 10108-33) | |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2022-03-17 |