| NPI | 1881074367 |
|---|---|
| Former Name | HEIDI MARIE WILDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 8169) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: MN CNS 0333) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2021-05-04 |