NPI | 1932464468 |
---|---|
Former Name | ANNALYSE VICTORIA KREGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 6452-33) |
Additional Taxonomies | 163WX0200X Registered Nurse, Oncology (Licence: WI 17809930) |
363LF0000X Nurse Practitioner, Family (Licence: WI 6452) | |
Enumeration Date | 2012-07-11 |
Last Update Date | 2018-12-28 |