| NPI | 1922000827 |
|---|---|
| Former Name | ILENE ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO APN.0993189-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP748022) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2017-11-20 |