NPI | 1871954552 |
---|---|
Former Name | AMANDA C MARSH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 77164) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016028880) |
Enumeration Date | 2016-03-09 |
Last Update Date | 2020-02-15 |